Sarcoidosis is a multisystem inflammatory disease of unknown etiology that predominantly affects the lungs and intrathoracic lymph nodes. Testicular sarcoidosis is a rare presentation of this disease. We review the case of a patient with stage 2 sarcoidosis with bilateral intrascrotal involvement along with classic pulmonary, lymphoid, and dermatological manifestations. We provide a literature review of testicular sarcoidosis and discuss the diagnostic challenges and the management of intrascrotal mass in setting of disseminated sarcoidosis. Copyright © 2014 by Lippincott Williams & Wilkins.