Two patients with lepromatous leprosy presenting initially because of lepromatous orchitis are reported. These cases are unusual because they were diagnosed as lepromatous orchitis at a stage when no other evidence of leprosy was present. Generalized skin lesions characteristic of lepromatous leprosy subsequently developed in one of these patients. It is suggested that lepromatous orchitis should be actively considered in the differential diagnosis of orchitis and infertility.