Scrotal paget disease is a rare skin malignancy, patients often present with erythema, desquamation, itching and other symptoms, with the basis of tissue biopsy for diagnosis, surgery is currently the preferred treatment. Scrotal paget disease is a rare malignant tumor that occurs on the skin of the scrotum, and is a special kind of epidermal carcinoma in situ. Early stage patients often show eczema-like changes in the scrotum, such as erythema, itching, flaking, and in severe cases, erosion and ulceration; late stage patients may show enlarged inguinal lymph nodes. When patients have similar symptoms, it is recommended to go to regular hospitals for timely consultation, and further diagnosis can be made by biopsy of scrotal lesions and magnetic resonance imaging (MRI). If the lesion tissue is small and not infiltrated, the edge of the skin will be examined by rapid frozen section during the operation, and finally the scrotal skin will be closed by simple suture; if the lesion tissue is large and not infiltrated, scrotal transfer flap plasty with tibial flap can be chosen. Scrotal paget disease is a rare skin malignancy, specific can consult the relevant professional doctors, the emergence of uncomfortable symptoms timely consultation, to avoid the deterioration of the condition.