Background: Juvenile gangrenous vasculitis of the scrotum is a rare entity that appears in young men, characteristically after an infection of the upper respiratory tract. Case report:We present the case of a 27-year-old male patient who presented with fever and scrotal ulcer after pharyngotonsillar symptoms. The differential diagnosis with other entities that present with scrotal ulcer is proposed, including Fournier's gangrene and vascular ulcer secondary to infection by the SARS-CoV-2 virus. Conclusions:The differential diagnosis of scrotal ulcers is a diagnostic challenge due to its low incidence. Correct identification of the causative entity is essential to determine an adequate therapeutic attitude.