Varicocele is a frequent disease in adolescents (15%) and has a harmful effect on growth of the testis and spermatogenesis, which deteriorates with increasing exposure time to varicocele. However, only 15 to 20% of adults with varicocele are infertile. It is currently impossible to predict, among adolescents with a varicocele, those who will subsequently be infertile. Testicular hypotrophy reflects testicular repercussions, but its correlation with subsequent infertility is unknown at the present time. However, treatment of varicocele allows correction of testicular hypotrophy. Although the arguments are still only speculative, testicular hypotrophy, together with symptomatic and/or grade III varicocele, represents a logical indication for treatment of varicocele in adolescents. Many techniques can be used to occlude the varicocele in adolescents. Open retroperitoneal surgery is currently the reference method.