A 65-year-old diabetic man presented with a painful swelling of his right epididymis. Urine culture was sterile. Semicastration was performed and histology revealed malacoplakia of the epididymis without involvement of the testis. Histologic workup demonstrated typical von Hansemann cells and Michaelis-Gutmann bodies stained by von Kossa's stain. This is the 19th case of epididymal malacoplakia and the 9th case of epididymal malacoplakia without concurrent involvement of the testis. Literature review shows that the present case is typical with respect to the clinical presentation and with regard to the age of presentation. The fact that this patient was suffering from diabetes mellitus lends some support to the assumption that a compromised immune status could be etiologic in malacoplakia.