A 3 year old Belgian gelding presented for evaluation of a scrotal swelling. The horse had been castrated in October 2003 and the scrotal swelling was first noticed the following spring. He presented in October 2004. Differentials for the scrotal swelling included hydrocele, scrotal hernia, and schirrhous cord formation. Diagnostics included CBC, chemistry, and ultrasound. Pre and post Ck levels were also evaluated to determine if the patient was a carrier for equine polysaccharide storage myopathy, which is commonly seen in draft horses and puts tham at a greater anesthetic risk due to muscle weakness and inability to rise following prolonged periods of recumbency. Surgical exploration of the scrotal swelling revealed a hyrocele of the right spermatic cord and herniated omentum within the left spermatic cord. The hyrocele and hernia were surgically corrected without complication.