Idiopathic scrotal calcinosis is characterised by the presence of multiple firm scrotal nodules of unknown or disputed aetiology. Only 55 cases have been reported in the literature since the first description by Lewinski (1883). We report an additional five patients. We have reviewed the literature exhaustively and our findings support the suggestion that the lesions of "idiopathic" scrotal calcinosis result simply from dystrophic calcification of epidermal cysts.