While testicular-sparing surgery (TSS) proves effective in reducing overtreatment in patients with small testicular lesions while maintaining oncological safety; scrotal US is used in the follow-up of the operated testis. Early postoperative US reveals diverse echotextures and haematomas. Late postoperative stages display subtle changes including albugineal and parenchymal scar and occasional testicular atrophy. Recurrent tumour patterns, though rare, have not been described at imaging. They may manifest as vascularised lesions adjacent to surgical scars. Additionally, metachronous tumours, more prevalent in patients with prior lesions, necessitate vigilant post-TTS monitoring. This chapter insights into post-TTS imaging, aiding clinicians in accurate diagnosis and effective management.