Synchronous bilateral testicular germ cell tumours (TGCT) of different origin are very rare; the simultaneous appearance of a TGCT with a contralateral benign non-germ cell tumour represents an even more seldom event. We report on three patients with nonseminomatous TGCT and a contralateral benign testis tumour being Leydig cell tumour, leiomyoma and epidermopid cyst, respectively. Patients were treated by radical orchiectomy in one case and by enucleation resection of the tumour in two cases. After follow-up of more than 5 years all patients are NED; no local recurrence occurred in the patients treated by tumour enucleation with their endogenous testosterone production being maintained. Although very rare the simultaneous appearance of a malignant TGCT and a contralateral benign intratesticular mass should be considered with bilateral tumours. Frozen section examination of the tumours might enable an organ sparing approach in benign testis tumours thereby maintaining endogenous testosterone production and fertility.