Brucellosis is a zoonotic disease that involved genitourinary system in 2-20% and most commonly cause single sided epididymo-orchitis. In our country Brucella is an endemic disease and causes serious and different diagnosis of acute scrotum and epididymoorchitis. In this paper six cases of epididymo-orchitis cases which were resistant to classical treatment were discussed according to clinical and laboratory findings. We describe different types of presentation of Brucella epididymoorchitis with diagnosis and treatment modalities. SummaryNo conflict of interest declared.Patient developed joint and muscle pain lately. At physical examination, body temperature was 37.2°C, swelling on right testicle with extensive tenderness was present, epididymis was hard, scrotum was erythematous and local temperature increased. Examination of other systems was normal. Scrotal color Doppler ultrasonography reported findings consistent with right epididymo-orchitis. Laboratory findings included leucocytes 8700/mm 3 , sedimentation rate 27 mm/h, CRP 30 mg/L and tube agglutination test positive at 1/160 titers. There was no growth in blood cultures. Patient was treated with rifampicin 600 mg/day, doxycycline 200 mg/day and anti-inflammatory treatment for 6 weeks. Symptoms were regressed after first week of treatment. There was no recurrence on the follow up. Case 2 (septicemia)A 63 year old male patient working with farm animals, presented with fever, night sweating and joint pain for 15 days For the last 2 days he had dysuria, swelling in the right testicle and pain. Physical examination showed 37.8°C body temperature, right epididymis very tender and swelling of the testicle, local erythema of the scrotum with temperature increase. Physical examination of other systems was normal. Laboratory results showed leucocyte count 13500/mm 3 , sedimentation rate 67 mm/h, CRP 70 mg/L, Brucella tube agglutination test positive for 1/640 titer. Brucella spp. growth was documented in blood cultures. Whereas there was no growth in urine culture. Patient' s treatment was planned for 6 weeks with rifampicin 600 mg/day, doxycycline 200 mg/day and anti-inflammatory treatment but in the second week of his treatment testicular pain was not regressed and patient continued to have frequent fever (38°C). One g/day streptomycin IM was added to treatment for two weeks and treatment was finished up to 6 weeks. After addition of streptomycin on the 3 rd day of treatment patient complaints were relieved dramatically. There was no relapse in 18 months follow up.Case 3 (acute scrotum, septicemia) A 27 year old male farmer presented with acute left testicular pain, fever, shivering, nausea and vomiting start-