Currently, no evidence determines the relationship between testicular microlithiasis by itself, or in relation with other factors, as a risk factor for the development of testicular tumors. There are no clear recommendations regarding the follow-up of this medical condition. Therefore, this review aims to provide a guide to monitoring these patients, supported by the literature. A literature review was carried out in December 2021 in PubMed, Cochrane, and Trip databases, and the selection of the articles was made following the PRISMA 2020 recommendations. Overall, the four systematic reviews chosen to conduct the final study determined that the combination of microlithiasis testicular with other risk factors further increased cancer development. However, the likelihood of testicular cancer risk is similar to that of the general population. Patients at risk of developing testicular cancer should undergo personalized monitoring according to their age, associated risk factors, infertility, and testicular dysgenesis syndrome to determine their follow-up needs or perform a testicular biopsy.