A case of seminal vesicle-rectal fistula is reported. A 74-year-old Japanese man was admitted to our hospital due to repeated right scrotal swelling and high fever with pneumaturia. A diagnosis of the right acute epididymitis was made. Bilateral vesiculography showed contrast medium leakage to the rectum, and colonoscopy revealed ostium of the fistula in the anterior wall of the rectum. Symptoms were improved by extirpation of the right scrotal contents.