Klinefelter syndrome (KS) is the most common sex chromosome aneuploidy. A distinctive characteristic of KS is oligozoospermia. Despite multiple studies that have described the natural history of the degenerative process of germ cells in patients with KS, the molecular mechanisms that initiate this process are not well characterized. MicroRNA (miRNA)-mediated post-transcriptional control mechanisms have been increasingly recognized as important regulators of spermatogenesis; however, only a few studies have evaluated the role of miRNAs in the gonadal failure of these patients. Here, we describe a differential expression profile for the miRNAs in testicular tissue samples taken from KS patients. We analysed testicular tissue samples from 4 KS patients and 5 control patients (obstructive azoospermia) through next-generation sequencing, which can provide information about the mechanisms involved in the degeneration of germ cells. A distinctive differential expression profile was identified for 166 miRNAs in the KS patients: 66 were upregulated, and 100 were downregulated. An interactome analysis was performed for 7 of the upregulated and the 20 downregulated miRNAs. The results showed that the target genes are involved in the development, proliferation, and differentiation processes of spermatogenesis, which may explain their role in the development of infertility. This is the first report of a miRNA expression profile generated from testicular tissue samples of KS patients. Klinefelter syndrome (KS) is the most common sex chromosome aneuploidy in humans, with a prevalence of 1:500 live births 1. It was first described in 1942 as a syndrome characterized by gynaecomastia, azoospermia, and elevated levels of follicle-stimulating hormone (FSH) 2. The presence of an extra X chromosome (47,XXY) in the standard male chromosome set (46,XY) causes Klinefelter syndrome. Chromosomal nondisjunction during meiosis or early embryonic mitosis causes this aneuploidy. Cytogenetic confirmation of aneuploidy is performed through conventional karyotype analysis. Approximately 85-90% of KS patients present with a 47,XXY chromosome set, while the remaining 10-15% of patients present with mosaicism (47,XXY/46,XY) or aneuploidies with more than three sex chromosomes (48,XXXY or 48,XXYY) 3,4. Sexual development in KS patients may be healthy before puberty, showing typical pubertal changes and levels of luteinizing hormone (LH), FSH, and testosterone 5. During adolescence, the testicles appear small and firm and the patient presents with multiple symptoms of androgen deficiency. Hypogonadotropic hypogonadism (HH) is the predominant characteristic, with testosterone levels below 12 nmol/L; low levels of insulin-like 3 (INSL 3), inhibin B and anti-Müllerian hormone (AMH); and high levels of FSH and LH 6. Infertility is one of the distinctive characteristics of KS, found in approximately 10% of azoospermia patients. During puberty, the testicles of KS patients grow to a volume of 6 ml; however, although the serum levels of testosterone increas...