Testicular involvement in connective tissue diseases (CTD) is typically caused by medium vessel vasculitis as in polyarteritis nodosa. Systemic lupus erythrematosus (SLE) and systemic sclerosis cause small vessel vasculitis, which is an unusual cause of orchitis. We hereby report a case of orchitis in a 28-year-old patient caused by vasculitis related to his lupus/scleroderma overlap CTD. He had an excellent response to steroids and azathioprine with complete resolution of his testicular and systemic symptoms. Our case highlights that although testicular involvement secondary to small vessel vasculitis in CTD is uncommon, it is still possible and should be evaluated.