OBJECTIVE To report an uncommon case of bilateral synchronous mixed testicular germ cell tumor. METHODS A young male had consulted at our urological services for a unilateral enlarged testis. A testicular tumor was suspected; scrotal US was performed, testicular tumor markers were determined and complementary studies to determine tumor extension were performed. RESULTS The US findings suggested a chronic inflammatory condition with bilateral diffuse infiltration, tuberculosis was discarded and bilateral testicular tumor was suspected, which was confirmed by bilateral intraoperative biopsy. A bilateral radical orchidectomy was performed. Adjuvant chemotherapy with cisplatin, VP-16 and bleomycin was administered after bilateral radical orchidectomy due to the attending risk factors for tumor recurrence. The patient is disease-free one year postoperatively. CONCLUSIONS Bilateral synchronous testicular germ cell tumors are rare. Scrotal US is a simple, noninvasive and efficient diagnostic imaging method; however, it does not provide pathognomonic images that could indicate the histological nature of the tumor.