['To evaluate the role of further grading of classical testicular microlithiasis (CTM) on the prevalence of associated testicular tumors.', 'Patients diagnosed with CTM using scrotal ultrasound over a 5-year period from a referral radiology clinic were included in this study. Patients with CTM were categorized as group 1 (grade I; 5-10 microliths/image), group 2 (grade II 10-20 microliths/image), and group 3 (grade III > 20 microliths/image). Other pathological findings were also recorded. The prevalence of testicular cancer was compared statistically between groups using the chi(2) test.', 'Seventy-eight of 4,310 (1.8%) patients were found to have CTM. Of these, 17 (21.7%) had ultrasonographically detected testicular cancer. In patients without CTM (n = 4,232), 58 (1.1%) testicular cancers were found. This accounted to a 19.7-fold increase in the detection rate of testicular cancer in patients with CTM compared to patients without CTM. The rates of testicular cancer detected in groups 2 and 3 were 25 (6/24) and 26.6% (4/15), respectively (p > 0.05), while it was 17.9% (7/39) in group 1.'] Does grading of classical testicular microlithiasis have no effect on the prevalence of associated testicular tumors?