There are multiple causes of small abdominal pain in 15-year-old girls, and it is important to make a differential diagnosis and management. The first step is still to check blood and urine HCG to exclude dangerous conditions such as ectopic pregnancy. After the ectopic pregnancy, ultrasound should be done to exclude ovarian cyst torsion, rupture and other acute abdominal manifestations. It is relatively common for girls to have ovarian cyst torsion and rupture, which usually manifests as acute lower abdominal pain, sometimes with nausea and vomiting. The examination reveals pressure pain in the lower abdomen, sometimes with rebound pain, and ultrasound with specific manifestations of ovarian cyst torsion and rupture, which generally requires emergency surgical treatment. Surgery should also be examined to exclude surgical abdominal pain conditions such as appendicitis, intestinal cramps, and urinary stones. Intestinal cramps generally present as transient abdominal pain, spasm-like, often improving after defecation and exhaustion, and are relatively common.