Describe the scrotal surgical approach for abdominoscrotal hydrocele (ASH) withpreservation of testicular function with midterm follow-up. Two patientsdiagnosed with ASH and contralateral testicular abnormalities. Both had scrotalcorrection for ASH, one had contralateral testicular neonatal torsion and the othercontralateral communicating hydrocele. Four-year follow-up no complications orrecurrence, and normal Anti-Mullerian hormone level. This pathology is a clinicaldiagnosis and it is treated with surgery via a scrotal approach, preventing sequels,contralateral complications and preservation of testicular function.