Benign mass lesions of the scrotum include spermatocele, hydrocele, varicocele, sperm granuloma after vasectomy, tuberculous masses, and epididymitis. A careful history and physical examination are paramount in making the diagnosis of a scrotal mass. Referral to a urologist is indicated for masses that do not transilluminate, are solid or fixed to the testicle, or for epididymitis that does not respond to antibiotics. Hydroceles associated with significant symptoms or with hernia and varicoceles with symptoms or associated infertility are also reasons for referral. After a sexual history is obtained, lesions of the anogenital area should be carefully inspected. Male partners of women with cervical dysplasia should be examined for evidence of human papillomavirus infection. Treatment of anogenital lesions resulting from a sexually transmitted disease involves both partners.