Introduction: Acute scrotum is a common reason for emergency consultation. Early scrotal exploration is mandatory if torsion of the testis suspected clinically. Objectives: To study management and clinical outcome of patients admitted with acute scrotal condition. Methods: This was a prospective observational study involving 60 patients hospitalized for Acute scrotum at tertiary rural centre, from September 2014 to September 2016. Patients admitted with complaints of acute pain and swelling of scrotum irrespective of age and gender were included in the study. Patient with painless scrotal swelling and those with chronic scrotal pain were excluded from the study. Patients were monitored post-operatively till discharge and followed for 1 month for any complications. Results: Of the 60 patients in our study, acute epididymo-orchitis (36.6%) was the dominant cause of acute scrotal swelling followed by scrotal abscess(23.3%). 51.6% of the patients were managed conservatively, which were diagnosed as epididymoorchitis and haematocele. 14 patients underwent incision and drainage who diagnosed as scrotal abscess; 7 patients diagnosed as fournier’s underwent debridement; 5 underwent orchidectomy or orchidopexy while 3 underwent B/L orchidopexy. Out of 8 cases of torsion of testis, bilateral orchidopexy was done in 3 cases (37.5%) in which we were able to salvage the affected testis. Out of the 60 patients, maximum patients (41 patients) required a hospital stay of 1-10 days. All patients were followed up for a period of 1month after discharge. None of the patients had any serious complications. Conclusion: Acute scrotum can be successfully managed by consevative methods after exclusion of Torsion of testis. Early exploration can salvage the testis in cases of torsion of testis.