Bilharzias is Schistosomiasis is prevalent in tropical and subtropical countries such as Yemen. Urogenital schistosomiasis can cause infertility in both males and females. Severe schistosomiasis can cause intense granulomatous epididymitis and inhibition of spermatogenesis, causing male factor infertility. This study reported a case of urogenital schistosomiasis had observed during semen analysis of a 36-year-old man, Ibn-Sina SP. Hospital. Sana'a, Yemen. A 1.8 mL clinical sample of liquid creamy coloured semen was collected. The progressive sperm motility and non-motile-died was 50% (R 40% and R 32%, respectively). The sperm count was 50.25 million/ml. Microscopic semen analysis showed slight sperm agglutination, many number of Schistosoma haematobium ova, extensive debris, and many pus cells. The sperm morphology was 81% normal and most abnormal sperm had small head with other abnormalities. The presented case confirms the clinical importance of adding a semen analysis to other diagnostic tests in male genital schistosomiasis particularly when there is a history or suspected fertility is a concern.