Epididymitis is a common clinical condition presenting as an acute or chronic form. Acute epididymitis is the inflammation of the epididymis accompanied by pain and swelling, while chronic epididymitis may present with pain only. Etiological factors may be infectious or non-infectious such as urinary obstruction, drugs, or idiopathic. Bacterial ascent through the urogenital tract is the most common etiology in acute epididymitis. Chlamydia trachomatis is isolated among all adult age groups. Consequently, sexually active patients with acute epididymitis should be screened for sexually transmitted diseases, regardless of their age. Diagnosis is generally based on patient history, symptoms, and clinical findings. Additional laboratory investigations and imaging may be required for differential diagnosis, particularly to exclude testicular torsion. Even though evidence-based recommendations for the antimicrobial treatment of acute epididymitis are limited, the majority of bacterial strains causing acute epididymitis are susceptible to fluoroquinoles and third-generation cephalosporins. For chronic epididymitis, a conservative approach may be beneficial; medical treatment employing antibiotics, anti-inflammatory agents, pain medication, and others are also being utilized. Spermatic cord block with short-term and long-term acting agents as well as surgical treatment are other treatment alternatives for patients with chronic epididymitis.