Two hundred and thirty patients had scrotal ultrasonography over an 18-month period. We report the ultrasound findings, correlation with the clinical diagnosis and, where possible, with the pathological diagnosis. The results show the value of scrotal ultrasonography in clinical practice. Of particular interest is the ultrasonic examination of the clinically normal or impalpable testis and the correct ultrasound diagnosis of testicular tumour in five cases (2% of all cases, 28% of tumours detected) thought clinically to be benign. A brief review of abnormal appearances is included.