Objective — to improve the results of surgical treatment of varicocele with use of microsurgical technique. Material and methods. Study included the results of surgical treatment of 105 patients with varicocele. I group (main) included 66 patients operated by method of clinic modification and II (comparing) group included patients operated by Ivanissevich method. I group in 41 (82%) had disturbance of spermatogenesis and 34 (68%) — had infertility. Results. After the operation in spermatic vein had diameter of 0.47±0.04 to 0.26±0.02 cm (p<0.05). Reduction in skin temperature gradient of the right half of the left scrotum by 1.45 to 0.37 deg was noted, which indirectly indicates the normalization of blood flow and eliminating blood stasis in the testis. Study group showed a significant increase in the number of sperm and their motility in the ejaculate by 50—70%, as well as a reduction in the number of immature germ cells by an average of 40%. In I group the pregnancy rate was 11.7%, in group II — 6.7%. Conclusions. The evaluation of the hemodynamic varicocele type by Doppler ultrasound and intraoperative flebotonometry in the spermatic vein system allows to choose the best way of operation and to prevent the development of recurrence. Us of the microsurgical techniques allows to ligate not only the collateral spermatic vein, but also periarterial trunks excluding intraoperative damage to testicular artery and lymph collectors.