Testicular pain has a variety of etiologies, including torsion, inflammation, trauma, and cancer. Differentiation of these diseases is important for proper treatment and prevention of further complications. A most noteworthy cause of testicular pain may be testicular torsion, in which a delayed diagnosis could result in the loss of the testis. Sonography plays a major role in the diagnosis of testicular torsion. Both gray-scale and color Doppler sonography aid in deriving a specific diagnosis that will help the physician in managing the condition. A case of an elderly man with testicular discomfort and complex hydrocele is presented.