A decidedly rare case of thrombophlebitis of left pampiniform plexus, causing acute development of a painful scroto-inguinal mass in a 28-year-old man with varicocele, is presented. The etiology of the disease remains obscure. A relationship to some unsuspected or indirect trauma or increased pressure in the pampiniform plexus has been postulated. Clinical features and difficulties in the differential diagnosis of other conditions producing acute cord enlargements are discussed with review of the literature. The diagnosis can be made preoperatively and condition can well be managed conservatively by antiphlogistic therapy. Oxerutina [O-(P-idrossietil)-rutosidea] has been used effectively and without adverse effects to control clinical signs and symptoms associated with thrombophlebitis of spermatic plexus. Surgical treatment of the varicocele, which may be a predisposing disease, is suggested after remission of inflammatory state to avoid relapses.