The aim of this study is to assess the role of percutaneous sperm aspiration in the cause of azoospermia and also to assess if this technique is sufficient to find enough motile sperm for ICSI. In order to increase the sensitivity of TESA, TESE is performed to patients who had no sperm with TESA. Between October 1995-October 1996 86 azoospermic patients included in to this study. Azoospermia is diagnosed by at least two semen analysis Semen is centrifugea at 1800g and assessed with inverted microscope under oil. After infiltrating cord and skin by Lidocaine %2 21G angiocath is inserted longitudinally to the testis. Afterwards, a 2ml syringe which contains a PBS medium is attached to the angiocath. Continuous negative pressure and changing the place of angiocath is applied until getting enough seminiferous fluid. This fluid is centrifugea at 400g and washed with Medicult. After incubating the pellet, examination is performed with an inverted microscope by using under oil microdrop technique. Motile sperm is retrieved in 62(72%) out of 86 patients. TESE is performed to 24 patients who had no sperm with percutaneous sperm aspiration. However, by TESE sperm is found in only 1 (4%) patient. According to these findings, percutaneous sperm aspiration technique revealed a sensitivity, specificity, positive and negative predictive value rates of 98%, 28%, 58% and 96%, respectively. These findings show that percutaneous sperm aspiration is a simple, reliable technique in the cause of azoospermia and also a suitable method for ICSI.