Two patients presented with unilateral hemiscrotal pain associated with clinical signs of inflammation. Testicular scintigraphy for testicular necrosis in both revealed no definite photopenia demonstrated in affected testes on planar images but were clearly demonstrated on SPECT. Both underwent orchiectomy of the affected side and the pathology proved necrosis. The search of the literature shows no previous report of similar documented case. The scintigraphic findings of these two cases are presented and the literature of ultrasonography and scintigraphy for evaluation of scrotal pain is reviewed.