We report our initial experience of laparoscopic ligation of varicocele in 13 patients with a mean age of 34 years (range 18-39). Eight patients were subfertile, and the rest complained of dragging pain and discomfort in the left scrotum. At laparoscopy the peritoneum overlying the spermatic vessels was divided, and the spermatic veins were mobilized, clipped, and divided. The spermatic artery was identified and preserved in 11 of the 13 cases. The patients were discharged within 24 h of hospital admission. Semen quality improved in seven of the eight subfertile patients studied with a mean follow-up of 8 months. Four patients who were operated on for pain and discomfort had symptomatic improvement by the time of their first outpatient visit at 3 months. One patient complained of paresthesia along the anterior aspect of his thigh, which resolved in 6 weeks. There were no other complications. Laparoscopic varicocelectomy is a safe and effective minimally invasive procedure for treatment of clinical varicocele.