Malignant Leydig cell tumor (LCT) of the testis are extremely rare and account for less than 0.2% of all testicular cancers. Testicular tumors of all histological types rarely occur in African American men. The authors describe a rare case of an advanced stage malignant LCT arising from the testicle of an African American man at the young age of 35, who presented with hemoptysis and a productive cough. Clinical features and treatment of Leydig cell tumor of the testis are discussed.