Paratesticular liposarcomas are rare malignant tumors originating from the adipose tissue of the spermatic cord or surrounding structures. Due to their rarity and nonspecific presentation, they are often misdiagnosed as benign scrotal masses or inguinal hernias.

We report a case of a 55-year-old male presenting with a gradually enlarging, non-trans-illuminant left scrotal swelling. Imaging revealed a fat density mass in the paratesticular region, and high inguinal orchidectomy was performed. Histopathological and immunohistochemical findings confirmed a well-differentiated sclerosing-type liposarcoma. No adjuvant therapy was given, and the patient remains on regular follow-up.

Paratesticular liposarcoma, though rare, should be considered in the differential diagnosis of scrotal masses, especially in older males. Surgical excision with negative margins remains the mainstay of treatment. Histopathology with immunohistochemistry is essential for accurate diagnosis and subtyping.