A transscrotal piercing is a body piercing that travels through the scrotum from front to back. This male genital piercing is an extremely advanced procedure, and is not done using a needle. Instead a scalpel or occasionally a dermal punch is used to make an incision, which is then followed by suturing the front to the back in order to create a viable fistula. Large gauge jewelry is usually then inserted into the incision. If the bond between the front and the back of the piercing holds, healing is very quick and easy. Should a bond fail to form, healing can be lengthy and problematic.

This is a serious, complex piercing, and should an infection develop, it can develop within the scrotum and becomes dangerous very quickly. This procedure is often considered to be a potentially dangerous surgical procedure, and is not by any means common.