Objective: To study the clinical profile, management and outcome of pregnancy complicated by adnexal torsion. Methods: All pregnancy cases complicated by adnexal torsion admitted between January 2001 and January 2009 were analyzed. Results: The total number of pregnant cases was 20. Age range of pregnant women with adnexal torsion was 18 to 42 years. Of these cases 70% were seen in the first and second trimester. Seventy percent of cases were operated by the laparotomy route and 30% by laparoscopy. Salpingo-oophorectomy was performed in 70% of cases and detorsion in 30% of cases. Histopathologic examinations revealed five patients (25%) had serous cystadenoma, four patients (20%) mucinous cystadenoma, six patients (20%) dermoid cyst and five patients (25%) hemorrhagic cyst. Conlusions: Adnexal torsion as a differential diagnosis of acute abdomen in pregnancy should be considered and we recommend early surgical treatment that will save the adnexa.