Surgery for male infertility has evolved into a highly specialized endeavor within the specialty of Urology. Most procedures in this field, including vasectomy reversal, varicocele ligation, and sperm retrieval are performed with microsurgery. In some Urology residency programs, training in male infertility may not be viewed as a priority and many Urology departments do not have a faculty member dedicated to this field. As a result, there is a perception among male infertility specialists that many urologists' training is deficient in this area. This chapter outlines the need and scope of microsurgical training in residency and reviews the impact of fellowship training on the practice of urologic microsurgery.