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High-frequency ultrasonography enables in clear demonstration of morphological alterations associated with acute scrotal inflammatory diseases, and colour Doppler sonography is highly sensitive in diagnosing acute scrotal pathology. In addition, Colour Doppler sonography accurately differentiates between testicular ischemia and torsion from acute inflammatory diseases in acute painful scrotal conditions.High frequency ultrasonography is highly sensitive in differentiating solid from cystic scrotal masses. High frequency ultrasonography is highly sensitive in detecting intratesticular microlithiasis. High frequency ultrasonography is invaluable in demonstrating normalcy of testes and epididymis in presence of large hydroceles.High frequency real time sonography is highly sensitive in distinguishing scrotal mass as either testicular or extra testicular masses and is clearly superior to clinical diagnosis. The advantages of High frequency US and colour Doppler includes non-invasiveness, lack of ionizing radiation, simplicity, wide availability, cost effectiveness and repeatability.High frequency ultrasonography with Doppler is highly sensitive in demonstrating the varicoceles.