Histamine-2 receptor antagonists are a class of drugs used to treat the acid-related gastrointestinal diseases such as ulcer and gastro-oesophageal reflux disease. Although such drugs, especially ranitidine and famotidine, are still widely used, their effects on semen quality, and hence on male infertility, is still unclear. This MiniReview systematically addresses and summarizes the effect of histamine-2 receptor antagonists (cimetidine, ranitidine, nizatidine and famotidine) on semen quality, particularly, on sperm function. Cimetidine appears to have adverse effects on semen quality. While the effects of ranitidine and nizatidine on semen quality are still controversial, famotidine does not appear to change semen quality. Therefore, additional studies will be required to clarify whether histamine-2 receptor-independent effects of these drugs play a role in semen quality as well as further clinical studies including direct comparison of the histamine-2 receptor antagonists.The histamine-2 (H2) receptors are widely expressed and can be found in gastric mucosal cells, heart, central nervous system, immune cells, smooth muscles of the airway, vasculature and uterus [1]. They are positively coupled to adenylate cyclase via Gs alpha subunit [2,3]. The activation of histamine-2 receptors by histamine alters the activity of Gs and therefore enhances the intracellular cyclic AMP (cAMP) production [3]. cAMP activates protein kinase A, which phosphorylates the cytoskeletal proteins, leading to the transport of the H + /K + ATPase (proton pump) from the cytoplasm to the plasma membrane of parietal cells [3,4]. H2 receptor activation stimulates hydrochloric acid secretion from the acidsecreting parietal cells of the gastric mucosa, leads to smooth muscle relaxation in the vasculature and airways, increases cardiac rate and contractility, and mediates some of the immunomodulatory effects of histamine [1]. Histamine-2 receptor antagonists (H2RAs), also called H 2 -blockers (e.g. cimetidine, ranitidine, nizatidine and famotidine), are the medications used to reduce the amount of hydrochloric acid produced by the stomach [5][6][7]. Mechanistically, these drugs are competitive antagonists of histamine-2 receptors [6,7]. In view of that, H2RAs are used to treat the acid-related gastrointestinal diseases such as gastrooesophageal reflux disease [8,9], dyspepsia [10-12], Zollinger-Ellison syndrome [13,14] and ulcer [15][16][17].Various studies have shown that proton pump inhibitors (e.g. omeprazole, lansoprazole, esomeprazole), another class of acid reducers with long-lasting reduction of gastric acid production [18,19], are more effective than H2RAs in treating acid-related gastrointestinal diseases such as gastrooesophageal reflux disease [20][21][22][23], ulcer [21,24], dyspepsia [25] and Zollinger-Ellison syndrome [26]; however, H2RAs are still widely used in the treatment of acid-related gastrointestinal diseases. One reason for this is that proton pump inhibitors therapy is more expensive and less cost-effective, ...