Scrotal emphysema and, less frequently, pneumatocele are uncommon sign
s of pneumoscrotum caused by a variety of pathogenic and iatrogenic di
sease processes. The finding of air in the scrotal sac may be an early
sign of a life-threatening condition or may represent an incidental f
inding associated with more benign conditions. The three basic mechani
sms by which air becomes localized to the scrotum are discussed, the l
iterature is reviewed, and 2 new cases are presented.