Abstract： This paper discusses the etiology， pathogenesis and treatment of male infertility from the perspective of the spleen and stomach based on syndrome differentiation. It is believed that the spleen and stomach are closely related to male reproduction. The spleen and stomach channel sinews are connected with male genitals to construct the channels and vessels basis of the treatment from the spleen and stomach based on syndrome differentiation. The spleen and stomach transforming and transporting the water and food are the material basis of essence and blood metaplasia. The normal ascending and descending of qi movement in the spleen and stomach are the key to regulating the accumulation of essence in the kidney and accumulation of blood in the liver. Phlegm-damp and static toxin are the pathological basis of male infertility. To treat male sterility from the spleen and stomach based on syndrome differentiation， Chinese medicine practitioners should focus on strengthening the spleen and stomach， freeing qi movement，take both the liver and kidney into account，and dispel the excess pathogenic factors.