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Introduction: Adnexal torsion is uncommon but emergent condition in pregnancy which is manifested with non specific symptoms. Adnexal torsion is an emergency in which ovary sometimes fallopain tubes twists upon its ligaments supports which comprise adnexal blood supply resulting in tisse ischaemia and ovarian necrosis .It is often misdiagnosed with other genital tract emergencies like PID, ectopic pregnancy, ruptured ovarian cysts and extra genital tract emergencies like appendicitis, renal colic, cholecystitos, intestinal obstruction .Early diagnosis and prompt treatment is required to preserve adnexa. Abortion can be prevented by reducing ovarian edema or tissue necrosis and avoiding abdomen pelvic inflammatory reaction.Diagnosis is particularly challenging in pregnancy owing to distortion of abdominal anatomy by Gracie uterus, difficulty of abdominal examination during pregnancy and wide range of potential diagnosis as it is associated with non specific symptoms. Case presentation: Primi with 12wks 4 days of gestational age (ML-6months) presented with ? sudden onset of pain on right iliac fossa associated with nausea and vomiting . On examination, abdomen is soft but there was localised tenderness present in right iliac fossa. On per vaginal examination uterus is midposition ~ 12wks, soft , mobile and tenderness noted in right fornix. On ultrasound enlarged right ovary of size 6*5*3 cm with no vascularity noted. Management: Right sided oophorectomy was done and specimen sent for HPE . Discussion: Existing literature in AT suggest that AT M/c in 28 to 38wks of gestational age. Pain appears to be the predominant symptom and is often sudden, constant and sharp m/c on right sides and usually unilateral associated with nausea and vomiting . Raised WBC present with fever in only minority of cases.US imaging performed and adnexal enlargement appears to be the most prevalent feature . MRI done if diagnosis is inconclusive. Conclusion: Prompt surgical management of AT is essential and surgery should not be delayed if diagnosis is clear as this can result in irreversible damage to ovarian tissue.