The value of ultrasound in testicular trauma with haematocele has been questioned inasmuch as the injured testis should always be explored surgically. Ultrasonography, however, plays an important role in the diagnosis and follow-up of patients with blunt scrotal trauma without haematocele. We have evaluated 17 such patients with real-time ultrasound. In 9 cases the testis and epididymis were normal to palpation, although in 6 of them parenchymal lesions, mainly subcapsular haematomas and parenchymal contusions not amenable to surgical intervention, were detected with ultrasonography. Seven patients presented with changes in the testicular or epididymal morphology at palpation and in 1 case the testes were not palpable. Ultrasonography was of great value, indicating surgery in 6 of these patients where physical examination alone was not sufficient to establish the need for surgical exploration.