This review focuses on the outcome, merits and demerits of intracytoplasmic sperm injection (ICSI) for treatment of male factor infertility. Spermatozoa of infertile men are surgically retrieved from the epididymis or testis. Fertilisation and pregnancy rates after ICSI are found to be around 66% and 48%, respectively, with surgically retrieved spermatozoa. Major contributing factors to failed fertilisation after ICSI are the number of metaphase II oocytes retrieved and availability of viable spermatozoa for injection. Children born after ICSI have an increased risk of major congenital deformity as compared with children born naturally. Both paternal and maternal risk factors seem to pose an increased risk of congenital malformations in the offspring born after ICSI. The ICSI technique per se is not an independent risk factor. Qualitative differences in development and social interaction between ICSI and natural children appears to be related to developmental processes of the entire family unit. Parents of ICSI children have a good relationship with their children.