BACKGROUND Experience with adnexa torsion in children, a rare but potentially severe pathology, is still disappointing despite constant radiological progress. METHODS The files of 19 patients with adnexial torsion treated between 1985 and 1995 were retrospectively reviewed and compared to those reported. RESULTS Eight adnexectomies, six oophorectomies, five detorsions with cystectomy and one salpingectomy were performed. There were only five salvaged adnexa in this series. Three tumors were found; all other cases, except three, were torsions induced by voluminous functional cysts. CONCLUSIONS Clinical context (sudden right pelvic pain without fever) seems important to note. Sonographic examination is first necessary, but its results are not accurate enough to confirm the torsion. Endo-rectal ultrasonography should become the best diagnostic method in cases of complicated ovaries. In order to increase the percentage of salvaged adnexa, the authors recommend a laparoscopic approach in emergency when clinical examination was doubtful.