Testicular torsion is one of the common causes of acute scrotum in adolescents. Early diagnosis and proper surgical management is crucial for testicular salvage. Although testicular torsion was first described in 1840, it is one of the most common reasons for malpractice lawsuits among adolescent boys. This review article aimed to highlight all clinical, diagnostic, and management aspects of testicular torsion, emphasizing on recent updates and experimental studies in that field. We reviewed already published articles in this context using PubMed, Medical Subject Headings database, Cochrane Central Register of Controlled Trials, and Google Scholar until April 2015. We used testicular torsion and acute scrotum as keywords. Most studies on this subject were correlated to management, differential diagnosis, surgical interventions, and experimental studies in the field of minimizing ischemia–reperfusion injury. Recent publications focused on providing highly sensitive and specific diagnostic methods and on improving the testicular salvage rate.