Introduction: An unusual case of 12-day old full-term infant with bilateral sycnchronous incarcerated inguinoscrotal hernia with bilateral undescended testes has been presented. The patient was brought with a gray-scale ultrasound report performed 8 hours ago in another center. Parents neglected the situation and 16 hours after the first onset of symptoms we performed emergency exploration. Intestines could be salvaged without any need for bowel resection. The right inguinal testicle had undergone hemorrhagic infarction and orchiectomy was performed. Dartos-pouch orchiopexy could be performed for the viable left inguinal testis. Diagnostic considerations have been discussed with special emphasis on the place of color Doppler imaging in acute scrotum.