Objective To observe the clinical efficacy of Spermatic vein ligation under microscope combined with traditional Chinese medicine in treatment of varicocele infertility. Method According to the random number table method, 80 patients with varicocele infertility admitted to our hospital from April 2021 to June 2022, were randomly divided into two groups, each group with 40 cases, the observation group underwent microscopic spermaceleous vein ligation combined with traditional Chinese medicine, and the control group was treated with microscopic spermatic vein ligation. Semen parameters (sperm concentration, forward motile sperm, normal form sperm, sperm DNA fragmentation index), sex hormone levels and natural pregnancy rate of spouses of the two groups were compared before and 6 months after surgery. Result Six months after surgery, the sperm concentration, forward motility sperm, normal morphologic sperm and sperm DNA fragmentation rate in the observation group were all improved, and the improvement rate in the observation group was significantly better than that in the control group, the differences were statistically significant(P＜0.05). The improvement of serum levels of testosterone, follicle stimulating hormone and luteinizing hormone in the observation group was better than that in the control group(P＜0.05). The total effective rate of the observation group was 87.5%, which was significantly better than 75.0% of the control group, and the natural pregnancy rate of the observation group was higher than that of the control group. Conclusion The effect of Spermatic vein ligation under microscope combined with traditional Chinese medicine in the treatment of varicocele sterility is satisfactory, and the semen parameters are obviously improved.