Paratesticular tumours are pathologically rare. The vast majority are benign in nature with adenomatoid tumours representing the most common pathological entity. We present the case of a 32-year-old man, from the Indian subcontinent, who presented with a painful scrotal swelling sustained after trauma. The history suggested that the scrotal mass had been present for approximately 12 months, and a preliminary diagnosis of a haemorrhagic cyst caused by trauma was made. Initial management included scrotal support, analgesia, and a follow-up magnetic resonance imaging (MRI) scan. Subsequent imaging and then further histological analysis confirmed a partly necrotic/infarcted adenomatoid tumour of the right epididymis. After scrotal exploration and epididymectomy, the patient made a complete recovery, and, with the histological diagnosis, he was discharged with no further followup. The case is presented as a learning point in the identification and management of such pathologies.