Only 4 infants with primary paratesticular neuroblastoma have been previously described. To the author's knowledge, this case would be the first report of a child who is older than 1 year whose lesion is in his right hemiscrotum. After simple tumorectomy was performed; he was tumor free at 4 years of follow-up. Patients older than 1 year with localized primary paratesticular neuroblastoma may have good prognosis after simple tumorectomy without further therapy.