Chronic testicular pain represents a management dilemma to clinicians and remains a very frustrating clinical problem. In nearly 25% of patients there is no obvious cause for idiopathic chronic orchialgia. Chronic testicular pain may occur at any age but the majority of patients are in 20–30 years of age group. The desired goal of the treatment is to allow the patient return to routine activity without significant use of analgesics. There is very little published material, in urology, about the etiology and treatment of idiopathic chronic orchialgia but situation is not bleak since many treatment options do exist which can allow the patient enjoy life with mechanisms for coping with pain. A multidisciplinary team approach is required, so that the patient can benefit from the different treatment options available at present.