Testicular torsion is the most common urological emergency characterized by reduced blood flow of the testis,often due to spermatic cord torsion occurring in adolescence. A 68-year-old male patient admitted our hospitalemergency service with the complaint of acute scrotal pain for a week. On history, he had undergone rightinguinal hernia repair with synthetic mesh one week ago. Due to reduced blood flow of right testicular arteryon colored doppler ultrasonography, emergent surgery was performed. On intraoperative examination, 360degree torsion of spermatic cord from distal to the mesh, thrombosis of right testicular artery and necrosis oftesticular tissue was observed. After detorsion of right testis, absence of blood supply to the right testis wasobserved. According to these findings, right inguinal orchiectomy was performed. It should be kept in mindthat persistent pain may be a sign of testicular torsion which may develop early after inguinal hernia repairwith synthetic polypropylene mesh. In suspicious of testicular torsion because of persistent scrotal pain afteringuinal surgery, scrotal colored doppler ultrasonography must be performed immediately and consulted to theurologist. Succeed results may be provided by multidisciplinary approach and early treatment.