Scrotal calcinosis is a rare condition characterized by multiple calcified nodules within scrotal skin. To our knowledge, only 67 cases have been reported to date. The etiology has been widely disputed and is viewed by many to be idiopathic. We describe a case of "idiopathic" scrotal calcinosis that not only presents a distinctly unusual clinical appearance, but also shows that at least some cases of this disease occur in association with dystrophic calcification of epidermal (follicular) cysts.