Adnexal torsion remains an infrequent and difficult to diagnose gynecologic emergency. Until recently, laparoscopic diagnosis was followed by laparotomy. Now, with proper laparoscopic technique, it is possible to untwist the adnexa or to remove it with excellent results. We report herein our cumulative four year experience with laparoscopic detorsion or removal of the adnexa in 41 patients. Ten patients were simultaneously pregnant, seven having the ovarian hyperstimulation syndrome, six with paraovarian cysts and 18 with idiopathic torsion. All of the women had an uneventful recovery, with 14 of 19 patients who claimed desire for pregnancy becoming pregnant within one year after the procedure, emphasizing its advantages and safety.