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Introduction: Torsion of the spermatic cord on undescended testis is a rare but serious surgical emergency. Material and Methods: We included 21 cases of torsion of an undescended testicle, operated on in the Department of Pediatric Surgery CHU Fatouma Bourguiba Monastir over a period of 16 years.Results: The mean age was 2 years. Sixty-two percent of patients were followed up for ectopic testicles and 42% of patients had cerebral palsy. Inguinal swelling was the reason for consultation in 95% of cases. Clinical examination revealed an irreducible painful hard inguinal swelling on palpation, with an empty homolateral bursa in all patients. The diagnosis of torsion of an ectopic testicle was made by Doppler ultrasound in 15 patients and confirmed by surgical exploration in all. For patients who underwent orchidopexy, long-term follow-up showed testicular atrophy in 2 patients.Conclusion: Torsion of an ectopic testicle is a diagnostic and therapeutic emergency, hence the importance of systematic screening for testicular ectopia.

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