Describe the scrotal surgical approach for abdominoscrotal hydrocele (ASH) with preservation of testicular function with midterm follow-up. Two patients diagnosed with ASH and contralateral testicular abnormalities. Both had scrotal correction for ASH, one had contralateral testicular neonatal torsion and the other contralateral communicating hydrocele. Four-year follow-up no complications or recurrence, and normal Anti-Mullerian hormone level. This pathology is a clinical diagnosis and it is treated with surgery via a scrotal approach, preventing sequels, contralateral complications and preservation of testicular function