Red scrotum syndrome is a chronic, difficult-to-recognize dermatosis affecting middle-aged and elderly people. It is manifested by erythema of the scrotum with clear boundaries, without neck. The etiology and pathogenesis of the disease have not been established. Hypotheses about the causes of dermatosis as a consequence of uncontrolled use of topical steroids, neurological inflammation, formation of microbial biofilm are based on anamnestic data and the results of trial treatments. Etiologically and pathogenetically justified therapy has not been proposed. Therapy with the use of doxycycline, gabapentin, pregabalin, indomethacin, tacrolimus was carried out in small groups of patients. The lack of clarity in the etiology and understanding of the mechanism of development of the disease explains the lack of a unified focus of the proposed therapies based on isolated clinical cases. In general, the problem of diagnosis and treatment rests on the absence of major clinical, epidemiological and laboratory studies that allowed to establish the pathophysiology and assess the true prevalence of red scrotum syndrome.