Introduction: To present the histopathological, etiologic aspects and the surgical procedure to treat a penoscrotal elephantiasis. Observation: A 60-year-old patient was referred for a giant scrotum for 30 years. His general status was poor. The scrotum was bulky, posed a cosmetic problem and limited the patient mobility. He underwent a surgical treatment with removal of the mass. Pathology of the specimen was suggestive of either a non specific fibrosis or a benign vascular tumor. Conclusion: Giant scrotum is rare. The treatment is surgical.