Male infertility, testicular tumors, and prostate cancer impose a substantial burden on male reproductive health and quality of life. Microcirculatory abnormalities are strongly correlated with the development and progression of these diseases; however, existing imaging modalities, constrained by their spatial resolution, are unable to visualize micrometer-scale microvascular structures in vivo. Ultrasound localization microscopy (ULM) combines imaging depth with high spatial resolution, surpassing the acoustic diffraction limit of conventional ultrasound and enabling the reconstruction of microvascular networks at the micrometer scale, while simultaneously providing multiple quantitative parameters. This article reviews the research progress of ULM in the diagnosis of andrological diseases and discusses the current challenges and future prospects.