We present the case of a 22-year-old man who sustained a gunshot wound to the scrotum. The imaging findings and management of the patient are described and discussed in the context of prior research pertaining to traumatic bladder rupture. Non-pressurized antegrade 10-minute delayed CT may result in unnecessary radiation exposure, delayed diagnosis and is not adequate to exclude bladder rupture. Retrograde pressurized CT cystography should be performed to exclude bladder rupture in patients with high-risk imaging results, clinical findings or injury mechanisms.