Seminal vesicles (SV) are accessory sex organs of male genitourinary (GU) tract, which play a crucial role in male fertility. Primary seminal vesicle abscess (SVA) is a rare pathologic entity with no specific symptoms with very few reported cases in literature, posing a great diagnostic difficulty to the clinicians. Common pathologies of seminal vesicle include cyst, congenital abnormalities and seminal vesicle infection, and abscess, secondary to obstruction and infection of the neighboring organs have been frequently addressed. Cross-sectional imaging advancement has expanded not only our knowledge of GU tract abnormalities but also our treatment approaches. Seminal vesicle abscess is a rare pathological condition and diagnosis is based on clinical and radiological findings. Conservative treatment could be effective in selected cases. In cases refractory to conservative management, surgical decompression can be an option. Transrectal ultrasonography-guided mini-invasive drainage modalities can be proposed successfully.