Vasectomy is a quick, safe, effective, and cost-effective contraceptive method, with a failure rate lower than that of female sterilization. Vasectomy can be performed in an outpatient with local anesthesia and minimal risks. Backup contraception should be used until motile sperm are absent on post-vasectomy semen analysis. One procedure can provide lifelong contraception. Despite its advantages, vasectomy is underutilized—only 4.5% of American women rely on vasectomy. Given that provider unfamiliarity may play a role in underutilization, a working knowledge of the vasectomy procedure is necessary for counseling couples on male permanent contraception. Training for this procedure is currently available in a growing number of family planning fellowship programs.