Ovarian torsion is the complete or partial rotation of the ovary upon its vascular pedicle with subsequent vascular compromise; it is one of a few gynecologic surgical emergencies requiring prompt diagnosis and treatment. The commonly accepted diagnostic sonographic finding in ovarian torsion is the absence of ovarian parenchymal blood flow using color or power Doppler imaging. However, since not all cases of ovarian torsion cause complete vascular obstruction, the presence of ovarian blood flow cannot eliminate this diagnosis in symptomatic patients with other positive sonographic findings. The case presented demonstrates the potential for a missed diagnosis of ovarian torsion when relying predominantly on Doppler findings.