The cases of 16 adult patients with spermatic cord sarcoma were retrospectively reviewed. Patient ages had a bimodal distribution (median 57.5 years). Presentation was scrotal mass, inguinal mass or both, with an average diameter of 6.7 cm. Radical orchiectomy was performed in 9 patients, and simple tumorectomy in 7. Lymph node dissection was performed in 6 patients, including retroperitoneal dissection in 4 patients. Various types of soft tissue sarcomas were found. Embryonal rhabdomyosarcomas were evident only in young patients. Lymph node metastases were found in 2 out of 6 cases. Testicular atrophy was observed in 3 young patients, germline destruction by the tumor in 2, and partial spermatogenesis in 2 patients. The median time to first relapse in 13 patients was 5.5 months. Surgery was the primary treatment and the best salvage modality. The role of chemotherapy and radiation therapy as true adjuvant or post-salvage-surgery adjunctive treatments remains unclear.