Abstract： Objective To explore the efficacy of microsurgical varicocelectomy in the treatment of varicocele(VC)and its influence on sperm quality and recurrence rate.Methods:Totally one hundred and twelve patients with VC who were treated in the hospital from December 2020 to December 2021 were divided into control group and observation group by the random number table method,with 56 cases in each group.The control group was treated with traditional open high ligation while the observation group was given microsurgical var-icocelectomy.The perioperative indicators in the two groups were recorded,and the Doppler ultrasound param-eters and sperm quality changes were observed in the two groups before surgery and at 6 months after surger-y.After 6 months of follow-up,the incidence rates of complications and recurrence rate of varicocele in the two groups were statistically analyzed.Results There were no statistical differences in intraoperative blood loss and hospital stay between the two groups(P＞0.05).The surgical time in observation group was longer than that in control group,but the Visual Analogue Scale(VAS)score at 3 days after surgery was lower compared with that in control group(P＜0.05).The spermatic vein reflux time and the maximum spermatic vein reflux velocity were shorter or slower in observation group than those in control group at 6 months after surgery(P＜0.05),but there was no statistical significance in spermatic vein diameter between the two groups(P＞0.05).The total sperm count,sperm concentration,proportion of grade A+B motile sperm and sperm motility rate in observation group were higher compared to control group at 6 months after surgery(P＜0.05).The in-cidence rates of postoperative complications in observation group were lower than those in control group(P＜0.05),but there was no statistically significant difference in the postoperative recurrence rate between the two groups(P＞0.05).Conclusion Microscopic varicocelectomy has a significant efficacy in the treatment of VC,and it can relieve the postoperative pain,improve the blood flow status of spermatic vein,enhance the sperm quality,and reduce the incidence rates of postoperative complications and recurrence rate,and it has ideal sur-gical effects.