To explore the application of modified scrotoscopic surgery (MSS) in the treatment of testicular hydrocele.We selected 45 cases of testicular hydrocele for this study, 22 treated by traditional scrotoscopic surgery (TSS) and the other 23 by MSS, which was performed with a pin-shaped electrode bent inward at an angle of 60° instead of a circular electrode used in TSS. We recorded the general clinical data, operation time, incision length, intraoperative injury, incision infection, scrotal edema, postoperative hospital stay and postoperative Visual Analogue Scale (VAS) scores of the patients and compared them between the two groups.There was no statistically significant difference in the general clinical data between the two groups (P > 0.05). Compared with the patients of the TSS group, those of the MSS group showed significantly shorter operative time (［32.86 ± 3.80］ vs ［26.13 ± 2.81］ min, P<0.05), incision length (［14.09 ± 2.23］ vs ［8.73 ± 1.48］ mm, P<0.05) and postoperative hospital stay (［4.36 ± 1.05］ vs ［2.00 ± 0.90］ d, P<0.05), and achieved remarkably lower VAS scores on postoperative days 1 (4.41 ± 1.05 vs 3.09 ± 0.79, P<0.05), 2 (3.36 ± 1.05 vs 2.78 ± 1.13, P<0.05), 3 (2.65 ± 0.72 vs 1.74 ± 0.86, P<0.05) and 7 (1.91 ± 0.81 vs 1.04 ± 0.82, P<0.05). At 3 and 7 days after surgery, scrotal edema was markedly milder in the MSS than in the TSS group (P<0.05). No testicular or epididymal damage, or wound infection occurred in either of the two groups.MSS is safe and effective in the treatment of testicular hydrocele, superior to TSS for its advantages of shorter operation time, smaller surgical incision, less postoperative pain and milder scrotal edema.