Color Doppler sonography is a well-accepted method for evaluating abnormalities of the scrotum and testes in children. The use of color Doppler sonography is especially important in acute diseases, allowing the evaluation of both perfusion and morphology. Most previous reports of the use of color Doppler sonography in the scrotum have been in adults [1-4]. In this pictorial essay, we illustrate normal and abnormal findings on color Doppler sonograms of the scrotum in children, particularly in prepubertal patients. Experience with vascular anatomy, inflammatory processes, testicular torsion, and tumors is emphasized.