Background: Adnexal torsion refers to the twisting of the ovary or ipsilateral fallopian tube or both, along the axis of their vascular pedicle. Present study was aimed to review role of laparoscopic surgery versus laparotomy in the management of ovarian torsion. Material and Methods: Present study was single-center, prospective, observational study, conducted in female patients with twisted ovary, diagnosed by clinical examination, ultrasonography and colour Doppler, confirmed intraoperatively. Results: In present study, 54 cases of ovarian torsion were studied. Majority were from 21-30 years age group (42.59 %), followed by < 20 years age group (20.37 %) & 11 (20.37 %) were postmenopausal. Common risk factors noted were presence of ovarian mass (94.44 %), parity > 2 (40.74 %), H/o tubal ligation (20.37 %) & PCOS (12.96 %). In present study common symptoms noted were acute abdomen (77.78 %), acute abdomen ± vomiting (64.81 %), chronic abdominal pain (>7 days) (20.37 %) & fever (12.96 %). USG diagnosis of torsion was given in 77.78 % cases. Ultrasonography imaging findings were simple/Hemorrhagic cyst (46.30 %), complex adnexal mass (42.59 %) & dermoid cyst (11.11 %). Mean diameter of the cysts was 7.8 ± 4.6 cm. USG Doppler was suggestive of absent blood flow (57.41 %) in majority of cases, low peripheral vascularity (20.37 %), & normal vascularity (22.22 %) was also noted. CT/MRI was done in 3 cases (5.56 %) to confirm diagnosis. Among them, 32 underwent laparotomy while 22 underwent laparoscopic surgery. Comparable distribution was noted for laterality & size of ovarian mass. Laparoscopy group had more conservative surgeries (p-<0.001), less radical surgeries (p-<0.001), less h Conclusion: Timely Laparoscopic approach remains the gold standard for the management of adnexal torsion and enables quick recovery, less hospital stay & complications.