Ovarian torsion is a surgical emergency, as it could lead to tissue necrosis and loss of fertility in the long term when diagnosis and intervention are delayed. In this study, the effectiveness of sonographic ovarian appearance in the decision of surgery and the clinical value of ovarian size in the diagnosis of torsion were investigated in premenarchal girls whose diagnosis of ovarian torsion was surgically verified.A retrospective cohort study design was utilized. Demographic characteristics, physical examination findings, laboratory findings, ultrasonography findings, operation records, pathology reports of 20 premenarchal girls who were admitted to Van Yuzuncu Yil University Medical Faculty Emergency Service between 2010-2020 and who were surgically confirmed to have torsion scanned and recorded.The cases included in the study were divided into two groups: nine patients with normal ovarian torsion (group1) and eleven patients with mass or cystic ovarian torsion (group2). Regarding the duration passed between admission to the emergency department and undergoing surgery, the time was shorter in group 2 compared to group 1 (13.54 ± 6.02 hours and 77.0 ± 101.86 hours respectively; p=0.053). Conservative surgical treatment was realized in all patients in Group 1 (9/9; 100%) and 7 patients in Group 2 (7/11; 63.6%); patients in Group 2 underwent cystectomy. Furthermore, oophorectomy was performed on 4 patients in Group 2. In terms of the torsion side, right-sided torsion predominance was detected in the ovary in both groups (6 patients (66.6%) in Group 1 and 7 patients (63.6%) in Group 2.Ovarian volume and Doppler flow could be considered as a potential predictive variable for ovarian torsion.