Testicular epidermoid cysts are benign tumours which account for less than 1% of all testicular tumours. Their uncertain histogenesis, difficult pre-operative diagnosis and controversial therapeutic approach are at the base of this paper. Report on two patients, 20- and 21-year old, with testicular epidermoid cysts treated by inguinal radical orchiectomy and tumorectomy, respectively. Literature review focused on the diagnostic and therapeutic aspects. Emphasis on the relevance of ultrasound for pre-operative diagnosis. We also advocate for a conservative management if their presence is suspected or in the presence of negative tumoral markers.