Swelling at the scrotum attached to the anus requires a relevant examination at the hospital to identify the specific cause. It may be an abscess in the perineal area, which is seen as localized swelling in the perineal area with hard nodules. When touched with the hand, it may be accompanied by a fluctuating sensation and the pain is progressively worse, affecting the patient’s ability to walk and sit. On physical examination, localized skin redness and swelling can be seen, and a localized bulging mass can be seen. A local ultrasound examination is required, and if pus is present, an incision and drainage is required. It may also be a perianal abscess, which may also form due to an anal fistula or perianal infection and accumulate in the area where the scrotum meets the anus, causing pain and even affecting urination and defecation when the abscess is large. Ultrasound examination is required and, if necessary, incision and drainage. It is also necessary to perform an anal finger examination to find out whether there is an anal fistula or an anal intestinal disease, and if necessary, to ask an anorectal doctor to collaborate in the diagnosis and treatment.