Acute scrotum is any clinical condition that manifests as acute painful swelling of the scrotum, and is often accompanied by poor general condition. It requires urgent medical or surgical intervention. The most common cause of acute scrotum is torsion of the testicular appendages, but can also occur due to testicular torsion, orchitis, hydrocele, pyocele, hematocele, epididymitis, epididymoorchitis, inguinal hernias, idiopathic scrotal edema, segmental testicular infarction, trauma, Henonch-Schönlein purpura and varicocele. Although differential diagnosis of acute scrotum is very broad, medical history and a detailed physical examination make it easier for us to make the correct diagnosis and thus facilitate the selection of the most appropriate treatment. Testicular torsion is a clinical diagnosis, and patients usually present with severe acute unilateral scrotal pain, nausea, vomiting, and poor general condition. If the anamnesis and physical examination suggest torsion, immediate surgical exploration is mandatory. The parenchyma of the testis receives about 9 ml of blood per gram of tissue per minute and is poorly resistant to ischemia, therefore if ischemia lasts longer than 6 hours, necrosis and loss of function occur and orchidectomy is required. As a result, the person is left without a testicle, which is a big problem especially for a young person because it affects fertility, and can have psychological connotations. In addition to the medical history and a detailed physical examination, ultrasound of the specified region is used to make a correct diagnosis, followed by "color-doppler" and laboratory tests. Most children, however, require surgical exploration, which is not only a therapeutic but also a diagnostic method.