Sonography of scrotal masses is now being evaluated as an adjunct to clinical examination in assessment of scrotal masses. The accuracy of ultrasound in discrimination of solid and cystic masses cannot be disputed. This paper will report on the reasons for referral, the sonographic diagnosis and effect on clinical management of 20 patients. Lesions examined include hydrocele, haematocele, epididymal lesions, abscess and solid testicular masses. A brief review of current literature will also be considered. An analysis will be made of diagnostic accuracy including ability to anatomically locate abnormalities.