Testicular torsion is a well known emergency situation in clinical urology. Usually cases with torsion of the testis, epididimis or Morgagni's hydatid present for operative emergency procedures due to an "acute scrotum". Also Amyand's hernia, anterior wall abscess, tumours of the testis or cholesterol granulomas have been described as mimicking a testicular torsion. We present the first case of thrombosis of an extraspermatic blood vessel as an unusual cause of an acute scrotum in 15-year-old boy.