HighlightsThe exact etiology of abdominoscrotal hydrocele is not known.Many theories such as, valve theory [1,2], diverticulum theory [1], displacement as per Laplace’s law [3] and increased production or decreased resorption of fluid [4] have been described in literature to explain the pathogenesis of this rare surgical entity.Surgical excision is the only therapeutic option for ASH. There is no role for conservative treatment.