Testicular torsion involves the testicle twisting which results in an infarcted testis. Emergency surgery is required to salvage the affected testis. There are 2 anatomic pathologies associated with testicular torsion: intravaginal testicular torsion and extravaginal testicular torsion (ETT). Extravaginal testicular torsion is seen perinatally and in neonates; beyond this period, ETT is regarded as exceptionally rare. This case series presents 7 cases of ETT seen in men aged 14 to 20 years. This is the largest and oldest group of patients seen with this pathology. These cases were defined by a pediatric surgeon in an inner city hospital in New York. Two patients' testes were not viable at the time of presentation, and the time of onset to presentation ranged from 30 minutes to 11 hours. Each of these cases had an orchiopexy concomitantly of the contralateral testis. This case series poses key questions regarding the etiology of ETT and the surgical management of such cases.