Objective: To evaluate the factors predicting favorability of spermatogenesis level. Design:Prospective cross sectional study. Setting: University Hospital Fertility clinic. Patient(s):95 patients with azoospermia underwent testicular biopsy were categorized using Johnsen score. Johnsen score of equal or more than eight was categorized as favorable and less than eight was not favorable. Intervention(s):None Main Outcome Measure(s): Sociodemographic, serum hormonal profile (FSH, LH and testosterone level) and testicular characteristic. Result(s): There were statistically significant association seen in patient with exposure to heat (p < 0.044) and smoking habit (p < 0.045), high FSH (p < 0.02) and low Testosterone (p < 0.04) level and small testicular volume right (p < 0.04) and left (p < 0.04) resulting in non favorable Johnsen score, thus reducing the chances of successful intracytoplasmic sperm injection. Conclusion(s):Spermatogenesis in azoospermic men were affected by exposure to heat and smoking habit, high FSH and low testosterone level with small testicular size.