The histories of 44 patients with adnexal torsion causing an acute surgical abdomen have been reviewed. The preoperative diagnosis was correct only eight times. A symptom complex together with relevant critical clinical and common laboratory findings are presented in an attempt to facilitate the diagnosis of adnexal torsion and differentiate it from other causes of the acute abdomen. The pathologic findings are emphasized as being benign. Laparotomy must be carried out in such patients, and salpingo-oophorectomy is the customary procedure.