The study of 155 patients with extra testicular scrotal lesions presented to SSG Hospital Baroda from December 2015 to November 2016 the following points can be emphasized. The commonest age group presenting with scrotal lesions was in the range of 31-40 years. Unilateral presentation was more common than bilateral presentation. The commonest presentation was scrotal swelling followed by pain and other associated complains of fever and urinary complaints. The commonest finding was cystic followed by inflammatory, and neoplasm being rare. Among cystic hydrocele was the main pathology followed by epididymal cystic lesions. Epididymitis was more common than epididymorchitis followed by Fournier's gangrene in inflammatory lesions. The commonest site of involvement was tunica vaginalis followed by epididymis and scrotal wall lesions. Ultrasonography helped to differentiate extra testicular lesions from intratesticular lesions in nearly all the cases, as well as the site of involvement but was not useful in confirming the etiology. FNAC was found useful in not only coming onto a final diagnosis but also had role in finding the etiology.