Testicular torsion is primarily diagnosed through a comprehensive physical examination, followed by diagnostic imaging. Doppler ultrasonography is the preferred imaging modality, as it effectively assesses blood flow to the testis, which is critical for confirming the diagnosis. Upon definitive diagnosis, immediate surgical intervention is essential to preserve testicular viability. It is crucial to differentiate testicular torsion from other conditions presenting with similar symptoms, such as epididymitis, hernia, or varicocele. While Doppler ultrasonography is typically the first-line investigation for acute cases, a radionuclide scan, which measures testicular blood flow, may be utilized in select non-emergent situations or when ultrasound findings are inconclusive, providing high diagnostic accuracy for various scrotal pathologies.