A congenital abnormal connection between an accessory spleen and a gonad is called splenogonadal fusion. The parent of a 3-y-old boy brought him to King Saud Medical City because he had left scrotal swelling that had begun 1 y previously. 99m Tc-sulfur colloid (SC) imaging has superior sensitivity and specificity in targeting the liver, spleen, and bone marrow, in that these are the only organs that 99m Tc-SC can visualize. Furthermore, if these tissues appear anywhere other than their usual locations, such as in the case of an accessory spleen, 99m Tc-SC imaging can identify them even without biopsy or-in the case of splenogonadal fusion-orchiectomy. In the current case, the patient underwent laparoscopy, the masses were removed, and orchiectomy was avoided. Histopathologic examination confirmed normal splenic tissue, matching the imaging results., (© 2022 by the Society of Nuclear Medicine and Molecular Imaging.)