Spermatic cord hematoma is a rare diagnosis. The etiology may be idiop
athic, traumatic, secondary to anticoagulation therapy, or as an exten
sion of a retroperitoneal hemorrhage. It has been misdiagnosed as an i
ncarcerated inguinal hernia, a testicular torsion, or a tumor. A revie
w of the English literature is presented. An additional case is presen
ted here as a complication of anticoagulation therapy after aortic val
ve replacement. Risk factors for a spermatic cord hematoma may warrant
an ultrasound examination.