Purpose: Traumatic testicular avulsion is rare and usually results in orchiectomy with loss of endocrine and reproductive potential. There is limited availability of emergency sperm banking to enable future family planning. We present a review of literature and a case report of emergency ectopic replantation of a testis into the thigh following trauma, with the objective of preserving viability for future hormonal and reproductive function. Methodology: A literature review of testicular replantation reported cases and outcomes was performed. A case report was presented of A 22-year-old male sustained a degloving auger drill injury to the groin, perineum, and penis, with complete traumatic orchidectomy. One intact testis with an intact pedicle was retrieved with the patient. After multidisciplinary discussion, urgent revascularisation to an ectopic site was attempted to maintain endocrine function and potential fertility through assisted reproductive techniques. Results: Through an anterolateral thigh incision, perforators to the tensor fascia lata and branches of the lateral circumflex femoral artery were dissected. Microvascular end-to-end anastomoses were performed between the testicular vessels and thigh perforators, with venous couplers for drainage. The testis demonstrated immediate perfusion and bleeding post-replantation. Post-operative ultrasound confirmed viability. At this stage, endocrine recovery is under surveillance, and surgical sperm retrieval is planned at a later date should spermatogenesis be maintained. Conclusions: This case highlights the technical feasibility of emergency ectopic testicular replantation into the thigh after traumatic orchidectomy. On review of the literature this appears to be one the first case of testicular replantation in Australia and the second documented case of ectopic replantation in English literature. It demonstrates a novel option to preserve hormonal function and provide future reproductive potential in severe genitoperineal trauma.