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Xanthogranulomatous orchitis (XGO) is an extremely rare inflammatory disease of the testis which can mimic testicular tumors. We report a 42-year-old man who presented with left scrotal swelling for one-month duration associated with pus discharge from the overlying scrotal skin. Scrotal ultrasonography revealed an atrophic heterogenous left testis with scrotal wall collection. Surgical scrotal exploration with left simple orchidectomy was performed. By histopathology, the diagnosis of XGO was rendered. The preoperative diagnosis of XGO can very challenging and the diagnosis mainly relies on histopathologic examination. Adequate pathologic sampling is essential to rule out the possibility of co-existing testicular neoplasms.