Angioleiomyoma of the scrotum is a rare benign lesion which can mimic a paratesticular tumor. Any solid mass within the scrotum is considered malignant until proven otherwise. Here, we present a case of an angioleiomyoma of the scrotum in a 33-year-old male who presented with painful scrotal mass. Scrotal ultrasonography demonstrated a solid mass in the scrotum, and surgical excision was carried out. Pathologic examination revealed that the tumor was angioleiomyoma. Copyright (C) 2011 Elsevier Taiwan LLC and the Chinese Medical Association. All rights reserved.