Ovarian torsion is an infrequent cause of acute abdominal pain in children. In these patients its etiology, diagnosis and treatment may differ significantly from that of adults. We show here our experience in 28 patients aged 9-16 during a seven years time frame (2008)(2009)(2010)(2011)(2012)(2013)(2014). All patients underwent trans-abdominal Ultrasonography (US) associated to Color Doppler Ultrasonography (CDU) and, in some selected cases, second level imaging methods. The surgical approach included open surgery or laparoscopy, either conservative (detorsion plus cystectomy/tumorectomy plus oophoropexy whenever appropriate) or radical, according to patient's conditions. Clinical presentation is non-specific and this frequently leads to diagnostic delay that might cause adnexal infarction. In case of acute abdominal pain, US is the most useful diagnostic tool, coupled with colorDoppler for the evaluation of blood circulation in the affected ovary.