Emphysematous epididymo-orchitis is a rare clinical entity. Up until July 2020, only 9 cases have been reported in PubMed and Scopus platforms, one of which also had scrotal involvement. Therefore, we are reporting the second case with prostate, seminal vesicle, and scrotal involvement. The condition represents an aggressive form of infection caused by gas-forming microbes. The radiological detection of air within the organs involved in the characteristic diagnostic sign. The case we are reporting is a 47 years old diabetic, chronic renal failure patient on regular hemodialysis who had a fulminant emphysematous infection in the left testis, epididymis, spermatic cord, the prostate, seminal vesicles, and the scrotum. Emergency orchiectomy has been carried out. The most significant part of the case is the pictures showing ballooning scrotum and gas bubbles in abnormal anatomical locations.