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Background and objective: In 10-20% of men with abnormal semen, azoosperima, the absence of sperm in ejaculation is common. Up to now, there has been no chance of pregnancy for couples in which the male partner had permanent azoospermia except by the use of donor insemination treatment but intracytoplasmic sperm injection (ICSI) has initiated a new era for azoospermic patients. The present study assessed the outcome of 50 consecutive ICSI cycles with spermatozoa surgically retrieved from azoospermic patients. Methods: In a male infertility center, 50 ICSI using precutaneouse epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE) was carried out in 30 obstructive and 20 non-obstructive azoospermic patients, respectively. Fertilization and pregnancy rates were compared in two groups. Findings: One hundred and seventy two and 116 MII oocyte were injected with motile or shaking sperm, which 69.2% and 64.6% were fertilized in obstructive and non-obstructive group, respectively. The clinical pregnancy rate were 23.3% and 25% in obstructive and non-obstructive group, respectively. The ongoing pregnancy rates were similar in two groups (20%). Conclusion: It seems that by using ICSI with a new sperm retrieval technique, the azoospermic patients could be potentially fertile.