Abstract: Objective To investigate the relationship between ultrasonographic characteristics and pathologic basis of testis epidermoid cyst. Methods Sonographic features of 25 patients with testis epidermoid cyst who underwent ultrasound examination in our hospital from January 2005 to April 2014 were retrospectively analyzed, and the diagnosis results and pathologic findings were compared and analyzed. Results Of the 25 cases with clear boundary and no blood flowing, 12 cases had onion skin or vortex shape changes, 9 cases was surrounded by a ring or shell-like hyperechoic, 1 case was cystic nodular, mainly in solid, surrounding with eggshell calci fication, 3 cases had both internal onion skin-like or vortex shape change and peripheral hyperechoic, 4 cases were heterogeneous hypoechoic nodules and showed multiple small pieces liquefaction zone and punctate echogenic. Ultrasonic diagnosis correct prompt testicular epidermoid cyst was found in 23 cases, and 2 cases were misdiagnosed as malignant tumors of testis. The diagnostic accuracy of high-frequency ultrasonography was 92% (23/25). Conclusion The ultrasonography of testicular epidermoid cyst has a certain characteristic. Differences with other testicular tumors especially the malignant testicular tumors can be found in cases who have atypical features through retrospective analysis, which have important clinical signi ficance to guide diagnosis for sonographer.