Radionuclide scrotal scintigraphy with 99m Tc-pertechnetate is an easy, well established, useful and readily available technique for evaluation of acute scrotum. We studied 41 cases of radionuclide scrotal scintigraphy and the results were as follows; 1. The over all diagnostic accuracy of scrotal scintigraphy was 93% (38/41 cases) 2. Scrotal scintigraphy was very useful and accurate in differential diagnosis of epididymo-orchitis and testicular torsion in patient with acute scrotal pain and swelling, while there was some limitation in differential diagnosis of hematoma from acute epididymo-orchitis or torsion. 3. Scintigraphy of epididymoorchitis showed increased perfusion and radiocativity in the epididymis and/or testics and its diagnostic accuracy was 90% (19/21 cases) 4. Acute testicular torsion showed normal flow in perfusion and cold defect occupying affected testis inn static image, while missed torsion showed slightly increased flow in perfusion image and cold defect surrounded by an uniform rim of hyperactivity (halo sign). Diagnostic accuracy of testicular torsion was 86%(6/7 cases)