Testicular torsion, also known as spermatic cord torsion, accounts for 25-35% of pediatric scrotal emergencies. This is because the torsion of the spermatic cord itself leads to impaired blood circulation to the testis, causing ischemia or even necrosis. Due to the strong contraction of the levator muscle spirally attached to the spermatic cord during strenuous exercise or violent injury to the scrotum, the torsion causes an acute blood circulation disorder to the testis. It often occurs in cases of congenital overgrowth of testicular tether, testicular lead dysplasia, cryptorchidism, incomplete testicular descent, incomplete connection between epididymis and testis, overactive epididymis and part of spermatic cord, and overgrowth of spermatic cord. There are two types of testicular torsion: intrasphincter type and extrasphincter type. The direction of testicular torsion is mostly from external to internal. Symptoms and signs 1.Symptoms Sudden severe pain in the scrotum, which may radiate to the lower abdomen or inner femur, accompanied by nausea, vomiting and other symptoms. 2.Examination The testicle is enlarged and moved upwards in a transverse position is the specific sign of the disease, with obvious tenderness and twisting and shortening of the spermatic cord in the shape of twine. If the pain does not decrease or increase when the scrotum is lifted or the testicle is moved, the Prehn’s sign is positive. The testes and epididymis are enlarged and poorly defined. The transillumination test is negative. Treatment Surgical exploration and testicular immobilization If manual repositioning fails, if testicular necrosis is suspected, or if the diagnosis of testicular torsion cannot be ruled out, immediate scrotal exploration should be performed. It is important to prevent undue delay in order to perform a specific examination, since testicular necrosis is associated with the timing of testicular torsion. Research data prove that the best results are obtained when patients are operated within 4h of the onset of symptoms, that the occurrence of later testicular atrophy will be significantly increased when torsion lasts for 8h or more, and that after 24h of torsion, salvaging the testis has lost its significance.