Our understanding of the causes of male infertility and our ability to develop an appropriate range of diagnostic tests are both dependent upon a knowledge of the cellular mechanisms responsible for the regulation of human sperm function. This review examines the intra- and extracellular factors regulating four separate components of human sperm function: sperm transport, sperm-egg recognition, the acrosome reaction and sperm-oocyte fusion. Within each of these areas the fundamental nature of the process, the control mechanisms involved, the availability of appropriate diagnostic tests and the relationship with human infertility have been considered.