This case report presents a 36-year-old man with elongated sperm morphology, a specific type of teratozoospermia, associated with oxidative stress and deoxyribonucleic acid (DNA) damage. Six months of supplementation of L-carnitine, acetyl-L-carnitine, CoQ10, zinc, and vitamins, combined with lifestyle modifications enhanced sperm motility, morphology, and quality significantly. Posttreatment semen analysis showed improved concentration (13-20 million/mL), progressive motility (25%-40%), and normal morphology (2%-7%). The couple underwent intracytoplasmic morphologically selected sperm injection (IMSI), leading to successful fertilization, production of high-quality embryos, and confirmed pregnancy. This case illuminates the therapeutic potential of L-carnitine and acetyl-L-carnitine supplementation, in combination with IMSI, in treating male infertility associated with abnormal sperm morphology and improving outcomes of assisted reproductive technology.