To assess the immediate (14 days) outcome of management and to determine the predisposing factors (PF) to acute epididymorchitis in this rural community. Materials and methods: This is a retrospective study. All men who were diagnosed as having acute epididymorchitis within the study period of 5 years were included. Those with epididymorchitis secondary to testicular tumors were excluded. Information related to age, HIV infection and other PF, organisms isolated, duration of hospital stay, antibiotic treatment, adjunct treatment, and duration of symptoms before presentation were documented. Immediate outcome was graded as good if symptoms and signs resolved within 2 weeks of treatment or poor if this took more than 2 weeks. Findings were analyzed using simple statistical methods and statistical package for the social sciences (SPSS-17). Results: A total of 58 men met the selection criteria and were included in the study. The risk factors included two (3.4%) prostatitis, 36 (62.1%) bladder outlet obstruction, three (5.2%) trauma/instrumentation, and ten (17.2%) multiple sexual partners. No risk factor was documented in seven (12.1%). One (1.7%) of the men, who also had bladder outlet obstruction, was HIV positive. When age was cross tabulated with risk factors, there was a significant correlation (P=0.000) but it had no significant effect on immediate management outcome (P=0.442). Immediate outcome was considered good in 40 (69%) and poor in 18 (31%). Independent factors that affected outcome included the duration of symptoms before presentation (P=0.000), presenting symptoms (P=0.000), and the need for adjunct treatment (P=0.018). Ciprofloxacin was the antibiotic used in 57 (98.28%), while cefuroxime was used in one (1.7%). These drugs had no statistically significant correlation with outcome. Conclusion: Many patients with epididymorchitis have PF that need to be treated to avoid its recurrence and complications. It would then mean that the diagnosis "acute epididymorchitis" is incomplete without including the PF. In this study, ciprofloxacin was not uniformly effective (69%) using the aforementioned criteria, indicating the need for prospective studies to identify cost-effective antibiotics.