Abstract Background Testicular microlithiasis (TM) is characterised by microcalcifications in the testes and has been associated with infertility. This has led to studies of semen analysis in men with the condition. This systematic review aimed to compare semen parameters in men with TM and those without. Men with classic TM (≥ 5 microcalcifications per sonographic image) were also compared to those with limited TM (