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This study aimed to compare the diagnostic value of testicular fine‐needle aspiration (FNA) with open biopsy in infertile males with azoospermia or severe oligozoospermia and to evaluate the reliability of testicular sperm extraction by FNA. A total of 76 testes of 40 patients, 34 with azoospermia, four oligozoospermia and two patients who underwent orchidectomy as a result of cancer of prostate were included. Detailed clinical and laboratory examinations were performed and two semen analyses were obtained from each patient. A 20‐ml 26 gauge 13‐mm needle was used for FNA and smears were stained with May–Grunwald–Giemsa and Papanicolaou stain. An open biopsy was performed in each patient after FNA and the samples were stained with haematoxylen–eosin. Smears and histological stains were examined and compared under light microscopy by the same pathologist. In 69 of the 76 testes (90 …