Vasectomy reversal has come a long way since the first anastomosis of the vas deferens and epididymis. Although its history is not as politically charged as that of vasectomy, the progress of reversal surgery has had its share of brilliant discoveries and missteps. In the early part of the twentieth century, vasovasostomy and vasoepididymostomy were esoteric procedures, but by the 1970s, a majority of urologists had some experience with reversal surgery. With the advent of microsurgical technique, reversal surgery has become once more a specialist's undertaking. The history of vasectomy reversal is an excellent case study in the evolution of surgery.