Paratesticular adenomatoid tumor (PAT) is the most common paratesticular tumor. It is still a concern for today's urologists because it cannot be distinguished from malignant testicular tumors by clinical symptoms, routine examination and imaging methods. Because of the predominant benign nature of paratesticular masses, testicular preservative treatments get to the foreground. However, the fact that virtually all of the solid scrotal masses are malignant and are treated with radicel ingainel orchiectomy (RIO) remains a cause of concern. In this study, we discuss the diagnosis and treatment of 12 paratesticular adenomatoid tumors treated between 2012 and 2017 in two centres. We suggest that a frozen section should be done with the help of an experienced pathologist; and a meticulous microscopic evaluation should be the gold standard in case of a benign tumor suspicion.