This study investigated the effects of Shengjing Zhuyu decoction in a rat model of varicocele. Following the successful establishment of the varicocele rat model, rats were administered Shengjing Zhuyu decoction at 15, 30, and 60 g/kg by gavage. The results revealed that Shengjing Zhuyu decoction improved testicular tissue injury and promoted spermatogenesis in the lumen. While no significant effects were observed in body mass and epididymal index, there was an increase in testicular index, sperm concentration, and motility. Moreover, Shengjing Zhuyu decoction suppressed hypoxia-inducible factor-1 alpha, vascular endothelial growth factor, B-cell lymphoma-2-associated X, and increased B-cell lymphoma-2 levels in the testis. In conclusion, Shengjing Zhuyu decoction can reduce spermatogenic function damage in rats with varicocele. The mechanism may be related to inhibiting spermatogenic cell apoptosis and reducing testicular damage caused by hypoxia.