The objective of this study was to analyze the clinical behavior and treatment policy of patients with primary testicular diffuse large B-cell lymphoma by retrospective analysis of 32 patients at our institute. All patients underwent orchidectomy. Anthracycline-based chemotherapy was administered to 27 patients (84·38%), six of whom also received rituximab; prophylactic intrathecal chemotherapy was given to seven patients (21·88%); and eight patients (25%) received prophylactic scrotal radiotherapy. Thirteen patients had relapse, among whom 12 cases were extranodal recurrences. Seven patients had central nervous system involvement, and four patients relapsed in the contralateral testis. The presence of B symptoms, poor Eastern Cooperative Oncology Group performance status, left testicular involvement, central nervous system involvement, and first relapse within 1 year were associated with worse progression-free survival using univariate analysis. Poor Eastern Cooperative Oncology Group performance status, left testicular involvement, and surgery alone were negative prognostic factors for overall survival.