We performed surgical treatment in 22 cases of torsion of the spermatic cord during the past sixteen years. Orchiopexy was performed in 9 cases, but in 13 cases orchiectomy was unavoidable. For five patients the visit to a doctor was too late. In five other cases a mistaken diagnosis was made by local medical doctors. Improvement of the success rate of orchiopexy requires that adolescents, their families and teachers should learn to recognize this disease, and doctors of other departments should recognize it as acute scrotum.