Abstract: Objecitve To study the ultrasound imaging characteristics of scrotum sarcoma. Methods Retrospective analyses of the ultrasound and clinical data of 9 patients with scrotum sarcoma were performed. Results Of the 9 patients, 5 had scrotum rhabdomyosarcoma, which included 2 cases of alveolus rhabdomyosarcoma and 3 cases of embryonic rhabdomyosarcoma (including 2 embryonic rhabdomyosarcoma of the tunica dartos in the scrotum). Their ultrasound imaging showed single or multiple hypoechoic mass located in the scrotum with distinct boundary and vascularity within the tumor. The other 4 patients had scrotum liposarcoma. The ultrasound imaging of 2 cases of scrotum liposarcoma displayed slightly hyperecho mass, while the other 2 cases displayed hyperecho and hypoechoic heterogeneous echo pattern. All of the mass had identifiable boundary and increased blood vessels. Conclusion Scrotum sarcoma is a rare malignant tumor of male genitalia. Scrotum ultrasound is useful for differentiating it from testicular tumor. The pathological feature of the tumor can be speculated according to the echo pattern and increased blood flow in the tumor.