A case of neonatal segmental testicular infarction in 1 testicle with complete infarction in the contralateral testicle is reported. Postoperative testicular function was documented by serum testosterone assay. To our knowledge this is the first case of neonatal testicular salvage in this setting documented by serum testosterone level. We hypothesize that vascular injury secondary to birth trauma was the likely cause in our case. The similarities and differences between this entity and neonatal extravaginal torsion of the spermatic cord are discussed.