Background: Infertility is a global problem. The re­gion with the highest rate of infertility included Cen­tral and Eastern Europe and Australia. The incidence is thought to be much higher in Sub-Saharan Africa, but the data is challenged by under-reporting. Despite most men with varicocele being fertile, it is still the most common diagnosis in infertile males.

Objective: The objective of the study is to evaluate the role of varicocele repair in improving semen param­eters and achieving spontaneous pregnancy by males with infertility and clinically palpable varicocele in SSA.

Methodology: A thorough systematic literature re­view was conducted from 1990 to 2022 using the vari­ous academic search engines: PubMed, Google Schol­ar, African Journal Online and Google. The English and French Literature was searched using the medical search heading (MEsH) Varicocele and Infertility in Male appended with the following indexes: Guidelines, Sub-Saharan Africa, Senegal, Liberia, Guinea, Ghana, Nigeria, Kenya, Uganda, Tanzania and Burkina Faso.

Results: there was a significant improvement in the semen parameters after varicocelectomy in SSA men ranging from 27.7% to 100% especially those with oligospermia. The mean pregnancy rate achieved in partners of SSA men after varicocelectomy was about 38.7%.

Conclusion: Conclusions drawn from several studies have shown significant improvement in semen pa­rameter and spontaneous pregnancy after varicocele repair in amongst couples with infertility. Males with infertility, clinically palpable varicocele and abnormal semen parameter should be offered varicocele repair.