ABSTRACT Objective To explore the value of ultrasound examine routinely scrotum diagnose testicular torsion with first presentation of abdominal pain. Methods The testis and spermatic cords were examined routinely in 1052 patients aged 11 to 18 with acute abdominal pain by high frequency two dimensional ultrasonography. Observe the testicular blood perfusion by CDFI. Patients were diagnosed testicular torsion by ultrasonography, should be treated by emergency surgical. Record the interval from onset of the disease to surgery,compare the results between ultrasonic diagnosis and surgery. Results In 1052 patients,ultrasound diagnosed testicular torsion in 7 cases, coincident with their surgical finds. There were 6 testis survived and 1 was necrotic after surgery. The interval from onset of the disease to surgery were 2.5-5 hours and 11 hours.Conclusion Examine routinely scrotum by high frequency ultrasound, testicular torsion with first presentation of abdominal pain were diagnosed promptly.