Abstract: Scrotal symptoms including palpable mass or pain often bring men to medical attention. Ultrasound serves as an extension of the physical examination in these patients and, in most cases, allows definitive diagnosis. Although the diagnosis of malignancy is of greatest concern both to the patient and clinician, a number of benign scrotal pathologies exist and most have characteristic imaging features. Knowledge of these imaging findings can help the radiologist to confidently identify common benign scrotal conditions. Location and imaging characteristics of uncommon lesions help to establish a rational differential diagnosis and appropriate recommendations for patient management.