The cystic swellings of scrotum are one among the commonest clinical entities faced by a surgeon in day to day practice and a cause of concern to the patient more with his fertility. Presenting with varied etiology they can represent a wide range of medical issues. Gold standard for the management of such cystic swellings of scrotum continues to be surgical extirpation of the lesion. Objective: To identify the cause, mode of presentation, various modalities of treatment and outcome of these with their complications. Method: A total of 170 cases of cystic swellings of scrotum fulfilling the methodology criteria were subjected to the preformatted study. Diagnosis was mostly by clinical examination and supported by ultrasonography. All cases were treated surgically with the appropriate surgical procedure. Results: Maximum patients were in the age group of 31-50 years and presented with scrotal swelling (59%) and more commonly affecting the right side. The commonest cause for cystic swelling of the scrotum was primary vaginal hydrocele (55%). Surgical procedure using Lords Plication was found to be simple, effective and associated with minimum post operative complications; the other conventional techniques like Partial/sub-total excision of sac, everson of sac were associated with more complications like haematoma, scrotal edema and infection. Majority of patients were discharged on 7th Post-operative day. Conclusion: The present study, primary vaginal hydrocele was the commonest cystic swelling of scrotum and treated surgically showed good results. Lord’s procedure was associated with the less post-operative complications, minimal tissue handling and good haemostatic control.