tuberculous epididymo-orchitis is a condition rarely encountered in countries where tuberculosis is uncommon. patients with scrotal symptoms are likely to be referred for ultrasound examination where an erroneous diagnosis of testicular tumour or non-specific epididymitis may be suggested unless the ultrasound practitioner is aware of the sonographic features of this condition. we report the ultrasound features in a patient with tuberculous epididymo-orchitis.