Male infertility is generally diagnosed by anamnesis, physical examination, and also semen analysis. But, in some cases, imaging methods need to be used for additional help to find out the cause of infertility. A literature search from the PubMed database was performed using keywords of male genital tract imaging, sperm quality impairment, and infertility cases to find appropriate articles, then all results were collected and selected. The most common cause of male infertility is varicocele semen analysis followed by testicular atrophy, microlithiasis, undescended testis (UDT) or inflammation, which can impair spermatogenesis. Ejaculatory duct obstruction also causes blockage of sperm passage. Additional knowledge of the mechanism of sperm quality impairment, and accompanied by male genital tract imaging, is expected to help the clinician to decide more specific pathological management in andrological cases.