Testicular microlithiasis (TM) is an un-common urologic condition incidentally diagnosed by scrotal ultrasound. It has been associated with different diseases, such as Klinefelter`s syndrome, testicular at-rophy, cryptorchidism, testicular torsion, and infertility. However, it can also present in healthy males that have no associated risk factors. Currently, TM is most often detected thanks to the superior resolution of today’s ultra-sound equipment, compared with former models. In the 1990s, TM was considered a benign condition with no important clinical relevance, but later reports associat-ed it with the development of testicular neoplasias and infertility. Thus, many authors recommended periodic surveillance with tumor markers and ultrasound imaging, with some even promoting the use of testicular biopsy. The aim of this article is to clearly and specifically pres-ent current information about testicular microlithiasis, to establish both diagnostic and follow-up indications.