Adnexal torsion is a critical gynecological condition characterized by the twisting of the ovary and/or fallopian tube, potentially leading to compromised vascular supply and subsequent organ damage. This chapter discusses the epidemiology, pathophysiology, clinical presentation, and diagnostic approaches for adnexal torsion. It primarily affects women of reproductive age but can occur in all age groups, including during prenatal and childhood periods. Common predisposing factors include adnexal masses, notably mature cystic teratomas, and increased adnexal mobility. Diagnostic imaging plays a pivotal role, with ultrasound (US) and color Doppler imaging serving as primary modalities for early detection, supplemented by computed tomography (CT) and magnetic resonance imaging (MRI) for detailed assessment. The chapter emphasizes the importance of prompt and accurate diagnosis to facilitate conservative surgical interventions that aim to preserve ovarian function. Additionally, it addresses specific conditions related to adnexal torsion, such as massive ovarian edema and isolated tubal torsion, underlining the variability in clinical presentations and the critical nature of imaging in diagnosis and management.