Introduction: Scrotal lymphedema is common in the tropics and subtropics. The giant variants can cause a lot of physical disability and psychological disturbances.
Case presentation: We present a 25-year-old Nigerian male with giant scrotal lymphedema with severe debilitating symptoms, immobility and emotional disturbance. He benefited from a modified Charles' procedure and reconstruction of the penile shaft using a split-thickness skin graft.
Conclusion: Giant scrotal lymphedema related to poverty, ignorance and neglect, is amenable to surgery. Surgery provides a cosmetically acceptable and functionally satisfying outcome.