Although hemangiomas are the most common benign tumors in infancy, scrotal hemangiomas are extremely rare and comprise less than 1% of all hemangiomas. Scrotal hemangiomas that extend into adjacent areas of the perineum, thigh, or anterior abdominal wall may occasionally be seen. Ultrasound is recommended as part of the preoperative assessment delineating the extent of a scrotal hemangioma. Since an absence of flow on Doppler studies does not exclude the diagnosis of hemangioma, MRI (magnetic resonance imaging) may provide more useful information for differentiation. In cases of cutaneous scrotal hemangiomas, conservative treatment that waits for involution is widely accepted. In patients with scrotal masses, exploration with excision is the treatment of choice even if a hemangioma is likely. The authors report a case of an intrascrotal tumor diagnosed preoperatively by color duplex ultrasonography and MRI in a 19-year-old male who subsequently underwent en bloc excision. Pathological examination identified a cavernous hemangioma.