Varicocele is an important cause of infertility which can be corrected by surgery. We aim to assess and compare efficacy of laparoscopic and open palomo`s technique for varicocele. A total of 70 patients were taken in our study to assess the efficacy of treatment. Open high ligation was done on 36 patients and laparoscopic high ligation was done on 34 patients. The hospital stay was more in patients of open group than of laparoscopic group. Also, patients of laparoscopic group returned to normal activities earlier than with open group. Recurrence rates were 0% and 5.6%, post-operative hydrocele occurrence was 2.9% and 8.3%, wound complication was 0% and 5.5%, scrotal edema was 2.9% and 8.3%, and orchitis was 0% and 2.8% in laparoscopic and open group respectively. Also, post-operative pain was more in open group. There was improvement in seminal analysis in patients of both groups. As compared to open high ligation, laparoscopic high ligation for varicocele has less postoperative morbidity, shorter convalescence and early return to normal activities.