Objective  To compare pain, discomfort, complications and convalescence during and after vasectomy performed conventionally or using the Li ‘no‐scalpel’ method. Patients and methods  Between March 1993 and May 1995, 256 men were vasectomized at two city hospitals in Copenhagen; half of the patients underwent the conventional technique at one hospital and the remaining half the Li method at the other. The two groups were matched for the time at which they underwent surgery and therefore for the duration of follow‐up. A questionnaire was sent to all patients, in which they scored pain and discomfort using a 10 cm visual analogue scale (VAS). The reproducibility of measurements was tested on 10 patients who had answered the same questions 1.5–2 years earlier. Results  Men vasectomized using the Li method experienced less pain at rest after the first week (P=0.05) and less use of analgesics (P<0.001), had fewer infections (P=0.0015) and contacts with their physician (P=0.0078) than those conventionally vasectomized. There were no significant differences between the groups for pain and discomfort during surgery and in the first week after vasectomy, frequency of bleeding, haematoma, oedema, granuloma, pain at activity, absence from work, vasectomy failure by sperm analysis, sexual activity and satisfaction with the cosmetic result (all P>0.05). Conclusion  Vasectomy using the Li method reduced post‐operative pain, the use of analgesics, the frequency of infections and contacts with a physician when compared with the conventional procedure.