The fastest evolving field in urology is certainly male reproductive medicine and surgery. Getting sperm and egg together is beyond what science fiction could have imagined only a few decades ago. Such remarkable progress created a whole host of issues including epidemiologic, surgical, medical, and societal. The authors contributing to this issue were asked to consider their topics today and a couple of decades into the future. As the foundations of reproductive genetics and the male endocrine system undergird all, they are explored in depth. Common conditions such as infection and inflammation, the ever problematic varicocele, and ejaculatory dysfunction are thoughtfully reviewed. The key to the modern management of male infertility, the evaluation and treatment of azoospermia whether it is due to obstruction or spermatogenic dysfunction, is discussed in detail. For the practicing urologist, the nuts and bolts of the infertility office visit, semen analysis and processing, and contraception are reviewed. With increasing public interest, nutraceuticals, lifestyle, and the environment's impact on male reproductive health are examined. And to put male reproductive dysfunction and its treatment in the broadest context, male reproductive epidemiology and reproductive health care delivery are explored. All of these topics are covered by leaders in male reproductive medical thought and practice.