Infertility affects approximately 17.5% of adults globally, with male factor contributing to 20–30% of cases. Oxidative stress (OS) is a critical factor in male infertility, disrupting the balance between reactive oxygen species (ROS) and antioxidants, which negatively impacts sperm function and viability. This review discusses diagnostic tools for OS markers, antioxidant levels, and intracellular ROS concentrations, enabling more accurate diagnosis and tailored treatment plans. Various treatment options, including empirical drugs, antioxidants, nanoantioxidants, and lifestyle modifications, are explored to address the root causes of male infertility. The review highlights the complex interplay of cellular components and physiological conditions contributing to ROS-mediated male infertility, emphasizing the importance of a multifaceted approach to diagnosis and treatment. By integrating innovative diagnostic techniques with evidence-based therapeutic modalities, clinicians can optimize treatment outcomes and enhance the chances of conception for couples struggling with infertility.Infertility affects approximately 17.5% of adults globally, with male factor contributing to 20–30% of cases. Oxidative stress (OS) is a critical factor in male infertility, disrupting the balance between reactive oxygen species (ROS) and antioxidants, which negatively impacts sperm function and viability. This review discusses diagnostic tools for OS markers, antioxidant levels, and intracellular ROS concentrations, enabling more accurate diagnosis and tailored treatment plans. Various treatment options, including empirical drugs, antioxidants, nanoantioxidants, and lifestyle modifications, are explored to address the root causes of male infertility. The review highlights the complex interplay of cellular components and physiological conditions contributing to ROS-mediated male infertility, emphasizing the importance of a multifaceted approach to diagnosis and treatment. By integrating innovative diagnostic techniques with evidence-based therapeutic modalities, clinicians can optimize treatment outcomes and enhance the chances of conception for couples struggling with infertility.