In the past month, we have seen four patients with acute testicular torsion. Unfortunately, because the patients were seen too late, three cases of ischemic necrosis of the torsioned testicle were found during surgery, and the torsioned testicle had to be removed even after repositioning, and only one case was successfully repositioned and the torsioned testicle survived. These patients have some common features that need to be noted, and if people have a little common sense about this disease and can seek medical attention in time, it may not result in serious consequences of testicular loss. This group of patients ranged in age from 13 to 61 years. Two of them were usually healthy, had a history of strenuous exercise playing basketball and running, and had a sudden onset of scrotal pain that dissipated into the lower abdomen and worsened after walking, and one of them vomited once. One had a viable testicle for 17 hours and one had a testicle loss for two days. One person had a left inguinal hernia with cryptorchidism for 61 years, with pain in the left inguinal region without clear cause and a painful egg-sized mass that did not disappear even after lying in bed, and testicular necrosis was diagnosed two days after the onset. A man had right cryptorchidism with right lower abdominal cystic mass for more than 40 years, and the mass was painful in the last week. The surgical diagnosis was ectopic giant syringomyelia with cryptorchid torsion, testicular atrophy to the size of a pea, and orchiectomy. The patient was discharged from the hospital 5-7 days after surgery with healing. After testicular torsion, whether or not necrosis occurs is closely related to the degree of torsion and the time of onset. After surgery at 4 hours of onset, the testicular function is basically unaffected; at 10 hours of onset, the salvage rate is only 50-70%; after 24 hours, it is only 10%. The disease can occur at any age, but is more common in adolescents, with about 2% of the testes torsioned bilaterally at the same time. The cause is not entirely clear, but may be related to congenital developmental defects, such as “pendulum” like testes, small testicular epididymal attachment points, inguinal hernia, cryptorchidism, and overgrown spermatic cord. The clinical manifestation is testicular pain, which may develop slowly or suddenly, with persistent and severe testicular pain, possibly reflex vomiting and nausea, increased pain to the touch of the scrotum, and gradually increased redness and swelling of the scrotum and hardening. Doppler ultrasonography blood flow measurement of the testicle is negative for vascular tone. Experts remind that if testicular pain occurs, especially in the adolescent population, or in those suffering from cryptorchidism and inguinal hernia (small intestinal gas), it is important to seek timely medical attention to protect the life source of men.