Abstract: Varicoceles are vascular lesions of pampiniform plexus and are the most common cause of male infertility. Although ultrasound is the most common way used to diagnose varicocele, there remains much controversy regarding their diagnosis and management, such as the ultrasonic diagnostic criteria and the classification of varicocele, the clinical value of ultrasound in observing the testicular volume with varicocele, whether the information derived from ultrasound is useful to help the clinicians provide intervention timely and appropriately. The literatures are reviewed in an effort to explore the pertinent controversies.