Azoospermia is a medical condition characterized by the complete absence of sperm in the ejaculate, making it a significant cause of male infertility. This condition is classified into two main types: obstructive azoospermia, where there is a blockage in the male reproductive tract that prevents sperm from entering the ejaculate, and non-obstructive azoospermia, which involves a problem with sperm production in the testes. Causes of azoospermia can vary and include genetic abnormalities, hormonal imbalances, varicocele, infections, ejaculatory duct obstruction, and exposure to certain chemicals or radiation. Testosterone plays a pivotal role in spermatogenesis, the process of sperm production, and its deficiency can be a contributing factor to non-obstructive azoospermia. The diagnosis of azoospermia involves a thorough medical history, physical examination, hormonal assessments, and multiple semen analyses to confirm the absence of sperm. Treatment options depend on the underlying cause and may include surgical correction for obstructive azoospermia, hormonal therapy to address hormonal imbalances, or assisted reproductive technologies (ART) such as in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) for cases where sperm retrieval is possible. The approach to managing azoospermia requires a personalized and multidisciplinary strategy to improve the chances of achieving fertility.