Small hard lumps in the scrotum appearing painful on pressure may be related to epididymal nodules, testicular nodules, testicular tumors and so on. 1. Epididymal nodule: commonly seen in epididymitis or chronic epididymitis, the sequelae caused by the lack of active standardized treatment, if accompanied by inflammation there may be swelling and pain. 2. Testicular nodules: usually secondary to orchitis, may appear localized hard nodules, and there may be swelling and pain in the acute stage. 3. Testicular tumor: it may be caused with trauma, endocrine abnormality, heredity and so on, and may manifest as testicular hard nodule. However, the pain is not obvious and can be felt when pressing. Small hard lumps in the scrotum appearing painful when pressed can also be seen in other causes, it is recommended to consult a doctor in time, follow the doctor’s instructions for relevant examinations, and deal with or treat with the help of the doctor.