A new microscopic technique for vasoepididymostomy is described. Conventional approaches to epididymal obstruction rely on the formation of a fistulous tract after the walls of the vas deferens are grossly sutured to the outer tunic of the epididymis; such methods have a low success rate. With a direct and accurate end-to-end anastomosis of the inner lumen of the vas deferens specifically to the epididymal tubule there is a greater likelihood of normal patency. Furthermore, such an anastomosis can be performed at the lowest possible level of the epididymis, allowing a greater opportunity for sperm maturation.