Adnexal torsion during pregnancy is a rare event mainly associated with the use of assisted reproductive techniques. However, it can occasionally also occur in spontaneous pregnancies without any predisposing factors. Its nonspecific clinical presentation in addition to the sometimes limited sensitivity of the gold standard test, Doppler ultrasound, leads to difficulty in preoperative diagnosis. For this reason, in most cases it is necessary to perform a laparoscopy in order to directly visualize the twisted ovary to obtain diagnostic confirmation. This is why, nowadays, adnexal torsion continues to be considered a diagnostic dilemma that should not delay the therapeutic approach, since a delay over 48 hours associates several irreversible lesions of the adnexa. At present, laparoscopy is the main surgical approach in pregnant women with suspicion of adnexal torsion due to the safety and advantages it provides. Keywords: Adnexal torsion, pregnancy, ovarian cyst, gynecological laparoscopy