Adnexal torsion is the twisting of part or all of the adnexa on its mesentery, resulting in tissue ischemia and frank infarction. This usually involves the ovary but may include the fallopian tube as well. Although this accounts for only 2% to 3% of all gynecologic operative emergencies, it is nonetheless a signiﬁcant event that often results in the loss of the ovary. Torsion of the adnexa is usually associated with the presence of an ovarian, tubal, or a paratubal mass (50% to 60% have an ovarian tumor or cyst). The risk of torsion is higher during pregnancy (20% of cases) or after ovulation induction. The average age of patients suffering adnexal torsion is in the mid-20s.