Scrotal or inguinal masses may represent inguinal hernias, hydroceles, or testicular torsion and are common findings in the newborn period. The clinician is challenged to differentiate between normal, abnormal, atypical, and pathologic findings and to seek urgent surgical consultation when compromised bowel, testis, or ovary is suspected. This issue of Focus on the Physical offers a review of the embryologic development of the processus vaginalis and testicular attachments to enhance the clinician's understanding of the development of these conditions. Systematic advanced physical assessment techniques will be provided along with pictures of common clinical findings. A brief discussion of the diagnostic studies that aid in differentiation of scrotal and inguinal masses and the clinical implications of each of these conditions will be discussed.