We report a case of scrotal abscess due to urethral fistula in a paraplegic patient with spinal cord injury. On clinical examination, an urinary catheters was placed, and the left scrotal area were swollen, redness and painless. Retrograde urethrography suggested an urethral fistula with extension spreading of contrast medium into the scrotum. The case was diagnosed as urethral fistula with scrotal abscess. The patient was successfully treated with cystostomy, scrotal incision, and pus drainage. Early detection and proper management provide opportunities to improve the outcome of this disease.