A bulge above the testicle in a baby is most often due to a syringomyelia or hernia. The underlying cause of both syringomyelia and hernia is due to unilateral or bilateral failure or delayed closure of the sphincter. The difference is that syringomyelia is usually not painful and has a positive transillumination test. In the case of a hernia, the mass usually appears and disappears, especially when the abdominal pressure increases, such as after exercise, but disappears when at rest, and the transillumination test is negative. Whether it is a syringomyelia or a hernia, as long as the child is older than one year old or has frequent impaction or infection, surgery is indicated and minimally invasive laparoscopic surgery is recommended to cure it. If recurrent impaction or syringomyelia is not resolved, it can cause testicular dysplasia on the affected side and should be treated promptly when surgery is indicated.