Varicocele is a medical condition characterized by an abnormal enlargement or dilation of the veins within the spermatic cord, which carry blood away from the testicle. This condition is often painless but can cause discomfort, heaviness, or a “dragging feeling” in the scrotum. When examined, the veins above the testicle feel like a “bag of worms.” The varicocele becomes smaller when the patient lies down and larger when standing up. While varicocele is uncommon in children under 10 years of age, it becomes more prevalent after puberty and affects 16% of adolescent boys, usually on the left side. The exact cause of varicocele is unknown. Varicoceles have been linked to infertility, with 20-40% of infertile men found to have a varicocele and low sperm counts. However, most men with varicoceles have normal sperm counts and are fertile. The increased temperature caused by the enlarged veins in the testicle is believed to impair sperm production. Although it is currently impossible to accurately predict which boys with varicoceles will experience fertility issues later in life, if the testicle on the side of the varicocele is smaller or not growing normally compared to the other side, this is considered a sign of ongoing damage and requires varicocele repair. Additionally, if the varicocele is large and causing pain, it should also be corrected. If there are no symptoms and both testicles are normal in size and growth, no treatment is necessary. Microsurgical subinguinal approach is one of the most effective and least invasive methods of treating varicocele. This involves making a small incision at the root of the scrotum and using an operating microscope to identify and ligate the affected veins on one or both sides.