Oztekin U, et al. - Researchers sought for the underlying etiological cause of varicocele. They assume that endothelial dysfunction, a precursor of vascular pathologies, may develop gradually and may have a substantial role in inducing atherosclerosis etiology. For assessing endothelial function, the most common noninvasive method is brachial artery flow-mediated dilatation (FMD) measurement with sensitive brachial artery ultrasonography. Similarly, subclinical atherosclerosis could be assessed via assessing carotid intima-media thickness (CIMT), using noninvasive ultrasonographic methods, and these findings may provide information on early changes in the vessel wall structure. Evaluation of a total of 128 patients was done in this study. The varicocele group vs the control group had significantly lower FMD (9.16 ± 3.34 vs 7.96 ± 1.88). The groups had similar CIMT measurements. As per multivariate logistic regression, there was an independent association of FMD with varicocele. Findings thereby suggest a role of endothelial dysfunction in the varicocele. Hence, they recommend evaluating every patient with symptomatic varicocele and performing regular follow up among them for cardiovascular pathologies.