Background: A testicular torsion is an acute surgical emergency which needs a prompt work up. Neonatal testicular torsion is an uncommon event. Aim of the work: This article aim to describe a case report of a neonate presented with testicular torsion and contralateral hydrocele. Results: Clinical and radiological management were discussed. Conclusion: The casedemonstrated that the possibility of uncommon presentation of acute scrotum such as testicular torsion with contralateral hydrocele can occur.