In the pediatric population, it is important to distinguish prepubertal from pubertal testis tumors. Benign tumors are more frequent in prepubertal boys. Teratoma is the most common histologic benign tumor in pediatric tumors. Germ cell tumors make up the majority of malignant testicular tumors. Tumor markers (AFP, hCG, and LDH) are most useful in diagnosis and staging. Ultrasound is the best imaging modality to diagnose testicular tumors. Testicular-sparing surgery is preferred in benign tumors. Lymphoma is the most common secondary testicular cancer and is more common in men older than 50 years than primary testicular cancer. When malignancy is suspected, scrotal violation through trans-scrotal biopsy or orchiectomy should be avoided due to the risk of local tumor seeding with recurrence and pelvic or inguinal lymph node metastasis.