We report a case of segmental testicular infarction occurring in a patient with sickle cell trait. A 20-year-old African American man presented with a complaint of sudden onset, acute severe left testicular pain for 24 hours. Scrotal ultrasound revealed a hypo-echoic mass in the left testicle. The hypo-echoic area demonstrated no blood flow in Doppler mode. Because malignancy could not be excluded, the patient underwent a standard inguinal testicular exploration. A partial orchiectomy was performed with complete excision of the lesion. Pathology revealed infarcted testicular tissue with no malignancy present. Further evaluation revealed that the patient had sickle cell trait unbeknownst to him.