Purpose: To identify the most predictive ultrasound parameters for the assessment of male infertility by a multiparametric study. Materials and Methods: A total of 64 males were recruited in the study group and 14 men in the control group. At first, grey-scale and color and Power Doppler ultrasonographic imaging was used to analyze testicular morphological characteristics and detect intratesticular abnormalities. Various ultrasound parameters of B-mode US and strain-elastography were related to total sperm count (TSC). Results: The prevalence of varicocele was not significant (P 5 0.33), though presented a 2.53-fold odds ratio The strain ratios of both testes, the volume of the left testis and the size of the left appendix were most associated with the results of semen analysis according to a Variable Importance in the Projection (VIP) score of >1. The first latent variable from the PLS analysis explained a significant amount of variance in TSC, concentration, and motility parameters (P < 0.0002) and showed that bilateral strain ratio, the size of the testis, and the volume of left appendix were the most significant US predictors of the pathological semen and sperm cell features. Conclusions: Our results showed that B-mode US with strain elastography is among more sensitive US approaches in evaluating male fertility.  Kulcsszavak: strain elastography, multiparametic ultrasound, male infertility