This study aimed to determine the gray scale and color Doppler sonographic features of the most common and some of the least common scrotal lesions. Between October 2012 to May 2013, 100 patients the age range of new born to 85 years old the mean 30.95, with scrotal symptoms, who underwent scrotal ultrasonography (US), were retrospectively reviewed. The clinical presentation, outcome, and US results were analyzed. The presentation symptoms including scrotal pain, painless scrotal mass or swelling, and trauma. Sonographic features that were reviewed included the size and echogenicity of the tumors, presence of cystic areas or calcifications,and distribution pattern of detectable blood flow on color or power Doppler imaging..This study revealed that of 100 patients the age range of new born to 85 years old the mean 30.95 (7%) presented with Testicular torsion , (10%) with epididymitis, epididymo-orchitis (13%), abscess (5%) ,encysted hydrocele (8%), varicocele (10%), Spermatocele (5%) , testicular malignancy (13%), orchitis (4%), hematoma 8 (8%), Scrotal hemia 6 (6%), undecended testis 8 (8%) and lymphoma (3%). Operation (orchiodectomy) was done for 6 pateint (one for testicular torsion ,second one inguinal hernia and undecended testis, ,two of seminoma and one unsenimotous disease). Color Doppler ultrasonography accurately diagnosed all cases of epididymitis or epididymo-orchitis, spermatic cord injury, testicular torsion, varicocele, and hydrocele .US provides excellent anatomic detail, The study concluded that Color Doppler ultrasonography is an excellent, a safe, and reliable method for evaluating patients with scrotal diseases. It aids in diagnosis of testicular tumors and reduces the number of unnecessary exploratory operations. It is especially important in conditions like testicular torsion where immediate diagnosis is required.