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.