Background: Varicocele is the most common cause of male infertility. It affects spermatogenesis by multiple theories; the most recent is by increasing the levels of reactive oxygen species. Medical treatment in the form of tamoxifen, anti-oxidant (Zinc) and MPFF (Micronised purified flavonoid fractions), may improve spermatogenesis and semen parameters in patients with varicocele. Aim: show the efficacy of medical treatment on semen parameters and varicocele degree in varicocele patients with oligoasthenoteratozoospermia (OAT). Patients and methods: This study included 60 male patients with varicocele and OAT. Clinical and radiological assessment of varicocele and WHO semen analysis have been performed before and 3 months after medical treatment. Patients were treated with Tamoxifen 20 mg / day, Oral Zinc and (Diosmin 450 mg and Hesperidin 50 mg) 3 time / day for 3 months. Results: There was a statistically significant increase in sperm concentration, progressive sperm motility, total sperm motility and sperm morphology (p =.009, .005, .020, 0.001) after 3 months of treatment. No significant changes in varicocele degree and veins diameter after treatment. Conclusion: Medical treatment has a significant beneficial effect on sperm concentration, progressive motility, morphology and total motility. It has no significant effect on decreasing vein diameter of varicocele or presence of reflux.