Varicocele, an abnormal enlargement of scrotal veins, is a common cause of impaired fertility in males, yet outcomes of varicocelectomy in adolescents remain limited in the literature. This retrospective chart review evaluated 26 adolescent patients (mean age 18.2 years) who underwent varicocelectomy at the Children’s Hospital of Philadelphia between 2013 and 2023, with both pre- and post-operative semen analyses available. Median follow-up time was 7 months (IQR 5–11). Results demonstrated that mean sperm concentration nearly doubled, increasing from 7.10M/mL pre-operatively to 13.3M/mL post-operatively. Semen volume showed a modest rise (2.6mL to 3.1mL), while motility remained largely unchanged (44.0% to 44.4%). Consequently, the average total motile sperm count nearly doubled, primarily driven by gains in concentration. These findings suggest that varicocelectomy in adolescents may enhance sperm production but has limited impact on motility and volume. Longer-term studies are warranted to assess whether these early improvements translate into meaningful fertility outcomes.