Abstract
Synchronous idiopathic bilateral testicular infarction is exceedingly rare and may mimic malignancy on clinical and radiological assessment. We report a 40-year-old male with bilateral avascular testicular lesions suspicious for germ cell tumour. Intraoperative frozen section during unilateral orchidectomy revealed necrosis without malignancy, avoiding unnecessary bilateral surgery. Final histopathology confirmed infarction with no systemic cause identified. This case highlights the diagnostic challenge of bilateral testicular masses and the value of intraoperative pathology in guiding management.