Microsurgical sperm aspiration is a specialized procedure in which sperm is aspirated directly from the male genital tract in cases where conventional sperm collection methods are not possible, commonly in cases of severe male factor infertility. These methods include testicular sperm extraction and percutaneous epididymal sperm aspiration for identification and retrieval of sperm from the testicles or the epididymis with the aid of microscopic instruments. This is a minimally invasive procedure under anesthesia that holds immense potential for help in cases of obstructive azoospermia or problems with sperm production. These sperms extracted can be used with assisted reproductive techniques like IVF or ICSI in an attempt to achieve successful conception and pregnancy.