Background:-Azoospermia is the medical condition of a man not having any sperm in his semen.Myeloid cell leukemia-1 (Mcl-1) is a member of the Bcl2 family of proteins involved in regulation of apoptosis. It is an inhibitor of programmed cell death. Objective:-Assess the immunohistochemical expression of MCL-1 in testicular biopsies in azoospermic patients and to correlate this expression with risk factors age, fertilization rate, quality of embryo and histopathological changes. Patients and methods:-This cohort study included 60 patients with azoospermia, 15 male with obstructive type and 45 males with nonobstructive type.Those patients were randomly selected form the population of infertile couples who regularly visits the High Institute for Infertility Diagnosis and ART and from Kamal Al-Samarai Hospital center of fertility. Result:-Mean histological H&E score was significantly higher in the obstructive group, 8.67 ±0.75 versus 4.82 ±2.60 (P<0.01). Additionally, mean MCL1 immunohistochemical score was significantly higher in the obstructive group than non-obstructive group, 2.73 ±0.46 versus 0.84 ±0.95 (P<0.001). Histological H and E score was highly significantly correlated with the immunohistochemical MCL1 score (r = 0.863, P<0.001). MCL1 score showed no significant correlation with the risk factors whereas it showed significant negative correlations with FSH, LH and prolactin and significant positive correlation with serum testosterone. Sperm isolation rate was significantly determined by higher histological and MCL 1 scores. Conclusion:-Histological H&E score and MCl-1 immunohistochemical score were significantly higher in the obstructive group than non-obstructive one, reflecting that apoptosis is higher in non-obstructive azoospermia and may have a role in its pathogenesis.