The clinical presentation of testicular torsion and ectopic pregnancy is similar to that of lancet, and both have a high mortality rate if not diagnosed promptly. The differential diagnosis of children with abdominal pain is extensive. It includes lesions of intra-abdominal organs and extra-abdominal organs. Both testicular torsion and ectopic pregnancy present with abdominal pain similar to that of lancet, both of which can lead to death if not diagnosed as soon as possible. Therefore, when a child presents with abdominal pain, a thorough physical examination, including examination of the genitalia, is very important. Testicular torsion requires rapid diagnosis and intervention in order to preserve the testicle. Spermatogenesis stops when the blood supply stops for 4-6 hours. Testicular torsion is the most common cause of testicular pain in boys older than 12 years of age and less common in boys younger than 10 years of age. Testicular torsion occurs when the testicular tract is too long so that the testicle is not well anchored within the scrotum, a solitary abnormality called testicular pendulum malformation. Painful testicular torsion is often manifested by pain and swelling of the testicle,. Although some cases present as abdominal pain. This pain usually appears suddenly without aura, and this pain may be accompanied by nausea and vomiting. Physical examination will reveal a swollen and erythematous scrotum, a horizontal rather than vertical position of the testicle, almost complete absence of the testicular reflex, abdominal pain due to torsion of the undescended testicle, and an empty scrotum on genital examination.