Infertility is characterized by the inability to conceive even after engaging in regular unprotected sexual intercourse for a period of 12 months or longer. Azoospermia affects around 1% of men. Approximately 60% of men diagnosed with azoospermia will have non-obstructive azoospermia (NOA). The main aim of this study is to investigate the potential relationship between preoperative hormonal profiles, testicular volume, and patient health factors with microdissection testicular sperm extraction (micro-TESE) outcomes in individuals with NOA. A retrospective analysis of 152 patients who underwent a micro-TESE operation for NOA at our center from January 2020 to December 2022 was conducted. Both groups were compared for age, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total and free testosterone, testicular volume before the operation, previous TESE, smoking, and medical illnesses. A relationship is considered significant when the value is less than .05. A total of 152 NOA patients were enrolled in this study. Patients were divided into two groups: first group, in whom sperms were identified during the procedure, representing 72 (47.3%) of patients, and the second group (52.7%) of patients, in whom no sperms were found. Results reveal that free testosterone level, total testosterone level, smoking, and previous TESE operation are significantly related to positive surgical results ( value < .05). Our findings suggest that preoperative total and free testosterone levels, smoking status, and previous micro-TESE operation may significantly affect the outcomes of micro-TESE.