Background and Objectives: The side effects of insecticides are undeniable due to their excessive use by farmers. This study aims to investigate the impact of spirotetramat insecticide on pathological and hormonal alteration in BALB/c mice testes. Methods: In this experimental study, 24 adult BALB/c male mice, with a body weight range of 25-30 g, were obtained from the Animal House of Uremia University and examined. Mice were randomly divided into three groups of eight: control, experimental group 1, and experimental group 2. The mice of experimental group 1 received 2.5 mg/kg, and experimental group 2 received 10 mg/kg of spirotetramat. The control group received the same amount of distilled water for 21 days through the mouth by gavage. After this period, the mice were anesthetized and evaluated. Data were analyzed using a 1-way analysis of variance in SPSS version 19 software. Results: The results of the study showed that spirotetramat increased the thickness of the tunica albuginea, the diameter of the seminiferous tubules, the differentiation index of the testis tube, and the spermiogenesis index, but it decreased the thickness of the epithelium of the spermatogenic tubules, the replacement index of active spermatogonia, Leydig cells, and FSH, LH, and testosterone hormone levels. The thickness of interstitial tissue, Sertoli, and lymphocyte cells did not change significantly. Conclusion: By inhibiting the activity of acetyl coenzyme A, spirotetramat insecticide disrupts energy production and prevents the synthesis of lipids in the cells, finally decreasing spermatogenesis in mice.