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Due to the rarity of scrotal squamous cell carcinoma (SCC), management of inguinal lymph nodes in scrotal SCC is largely extrapolated from management guidelines for penile SCC. This case report aims to enhance clarity on the management of inguinal lymph nodes in scrotal SCC. We recommend that for clinically node-negative patients, invasive techniques for lymph node sampling should be strongly considered and followed up with a radical inguinal lymph node dissection (ILND) where positive for lymph node metastasis. In the setting of clinically palpable lymph nodes which appear suspicious for metastasis on imaging, upfront radical ILND should be considered.