Scrotal involvement has been reported from 2% to 38% of males with Henoch–Schönlein purpura (HSP). It may present before the rash occurs or even long time after it has disappeared. Scrotal involvement of HSP usually results in pain, tenderness, swelling or discoloration of scrotum. Scrotal pain sometimes mimics testicular torsion to various degrees, which can be followed by unnecessary operative indication. In our 2 cases, one 5-year and 11-month-old boy came to our emergency department complaining of scrotal pain before the diagnosis of HSP, and the other 5-year and 1-month-old boy came to the outpatient center complaining of scrotal pain after the resolution of HSP about 1 month before the visit. We performed Doppler ultrasonography (USG) to evaluate the acute scrotal pain in the two boys. On Doppler USG, epididymis showed increased blood flow, and testis showed normal blood flow. These findings enabled the diagnosis of acute epididymitis and excluded testicular torsion. Epididymitis was improved by conservative management including short-term steroid therapy within 5 days. It seems to be important to perform adequate evaluation tools such as Doppler USG in the early course of acute scrotum of HSP, to avoid unnecessary scrotal exploration.