Background: Hydrocele accounts for 1% of adult men. Hydrocelectomy considered gold standard , there has been renewed interest in alternatives like aspiration and sclerotherapy, which is less invasive, has less morbidity and complications. Aim: To assess outcomes and cost associated with surgery versus sclerotherapy as management of hydrocele Materials and Methods: This retrospective study from June 2020 to dec 2022 conducted in department of general surgery,tertiary care center – kalaburagi. Patients who underwent surgical treatment through the Jaboulay technique(n=76) and sclerotherapy (n=60) evaluated. Results: The mean age for surgery 52 yrs versus sclerotherapy 56 yrs,mean time between onset of hydrocele and first outpatient evaluation was 34 months for surgery versus 40 months sclerotherapy,mean volume aspiratedwas 475mL for surgery and 375mL sclerotherapy, mean hospital stay duration for surgery group was 48hrs and sclerotherapy 4 hrs,mean follow-up period was 60 days after surgery and 30 days sclerotherapy. No significant complications occurred in any patient, mean cost per patient was INR 1500 rupees in Surgery Group and 500 rupees Sclerotherapy Group. Conclusion: Sclerotherapy is cost effective management for hydrocele compared to Jaboulay procedure with high success rate, lesser complications, fast discharge.