Varicocelectomy has been found to improve the spermogram in many subfertile men. However, there still remains a sizable group of subfertile men whose counts fail to improve sufficiently following surgery. Clomiphene citrate, which has been shown to improve fertility in idiopathic oligospermia, was similarly tried in men with varicoceles. The counts of 71% were raised to the low-normal range, and 36% achieved pregnancies. Medical therapy with clomiphene citrate may prove not only to be a useful adjunct to varicocelectomy but may prove to be first-line therapy for counts under 10 million/ml (8 of 13 improved to over 20 million/ml) when surgical therapy has not been successful.