Objective To improve the level of diagnosis and treatment through analyzing the clinical characteristics,treatment and prognosis with testicular torsion in children.Methods We conducted a retrospective analysis of 221 boys with testicular torsion,who received trearment from May 2003 to May 2023 at the Children's Hospital of Chongqing Medical University and Guizhou Provincial People's Hospital.Data analysed included:clinical characteristics,treatment progress and outcome.Results The peak onset age of testicular torsion in children was infancy and prepuberty(71％).The incidence of left side(77％)was higher than that of right side(23％).The first symptoms were mainly scrotal pain and swelling(62％),but some cases mainly manifested lower abdominal pain and inguinal pain(11％).The rate of misdiagnosis and mistreatment of patients in basic hospitals was high.Scrotal color Doppler ultrasonography is the first choice for assistant examination,and mainly showed none or dramatically decrease of blood supply in testis,and abnormal axial direction.The golden time for testicular torsion diagnosis was within 8 hours.The chief pathological manifestation were interstitial hyperemia,edema and seminiferous tubules degeneration within 8 hours,and hemorrhagic necrosis or infarction over 8 hours.Conclusions Children Testicular torsion occurs more frequently in infancy and prepuberty,torsion position in the left side is more than that in right side.The main symptoms are scrotal pain and swelling,as well as lower abdominal or inguinal pain.Testicular pathological lesion is closely associated with the diagnosis time and degree of torsion.