Varicocele is a common male reproductive disorder that can negatively affect spermatogenesis and fertility. However, not all men with varicocele develop infertility, making it crucial to identify reliable prognostic factors. This study analyzes clinical, anatomical, hormonal, and pathophysiological parameters that predict infertility in patients with varicocele. Key indicators include varicocele grade, testicular volume and asymmetry, semen quality, hormonal profile, oxidative stress markers, and patient-related factors such as age and lifestyle. Early identification of high-risk patients allows for timely intervention, individualized treatment planning, and optimization of reproductive outcomes. Understanding these prognostic determinants is essential for evidence-based management and preservation of male fertility.