ABSTRACT Aim There is no diagnostic method available to make a definitive preoperative diagnosis of adnexal torsion currently. The aim of the study was to evaluate the predictive value of systemic immune‐inflammation index (SII), systemic inflammatory response index (SIRI), and pan‐immune‐inflammation value (PIV) for adnexal torsion diagnosis. Methods A total of 469 women who were operated on with the diagnosis of adnexal mass were included in the retrospective cohort study. According to intraoperative adnexal torsion diagnosis, the study population was divided into the torsion group (103 women) and the control group (366 women). Demographic, laboratory, ultrasonographic findings, and inflammatory indices of the two groups were compared. SII, SIRI, and PIV were calculated using preoperative complete blood count results. Results The mean SIRI (3537 ± 3781 vs. 1656 ± 236), SII (1669 ± 1408 vs. 805 ± 901), and PIV (106 421 ± 129 428 vs. 50 466 ± 74 302) values were higher in the torsion group than the control. According to the ROC curve analysis, the optimal cut‐off values of SIRI (AUC 0.731), SII (AUC 0.755), and PIV (AUC 0.706) for predicting adnexal torsion were found as 1438, 944, and 62 557, respectively. Conclusion The study results showed that the SII, SIRI, and PIV significantly increased in adnexal torsion cases. Evaluating these inflammatory indices together with ultrasonographic findings may facilitate the diagnosis of adnexal torsion.