Testicular cancer is the most common malignancy affecting young men in their third or fourth decade with an incidence of three to six new cases per 100,000 males each year. When diagnosed and treated in its early stages, it has an excellent cure rate. 7-11% of patients with testicular cancer present initially with gynaecomastia. This may precede the presence of a palpable testicular tumour or hormonal abnormalities. This article evaluates the association between gynaecomastia and testicular cancer and recommends appropriate management for patients presenting with gynaecomastia.