Tuberculous epididymitis in a 27 y/o male. He presented with painless induration in the head of epididymis and underwent epididymyectomy. He had been treated several years back for tuberculosis in the same location. Serial sectioning of the specimen showed soft central areas of caseous necrosis surrounded by firm fibrotic areas. The vast majority of cases of tubuerculous epididymitis are accompanied by involvement of testis or other adjoining structures. Tuberculous epididymo-orchitis has made a resurgence in the US given the frequency of international travel, immigration from developing countries with a high incidence of the disease, and increasing population of immunocompromised individuals.