Inflammatory myofibroblastic tumor (IMT) is an uncommon condition and only a few cases of IMT in the spermatic cord have been reported, with none associated with an undescended testis. We present the case of a man with an undescended left testis who had an IMT involving the spermatic cord. He was treated with surgery and no adjuvant therapy afterward. He was disease free at 2.5 years of follow-up. A brief discussion of the pathologic features and management of the condition is also provided.