Abstract
Undescended testis (UDT) is the most common congenital urological anomaly. The primary concerns warranting surgical intervention include an increased risk of malignancy, infertility, and testicular torsion. Although testicular torsion is rare, it is a serious complication that can lead to ischemic injury and organ loss if not promptly diagnosed and managed. Bilateral undiagnosed UDT with torsion in an ipsilateral palpable testis is even more rarely reported. We present a similar case of a six-year-old male with bilateral undescended testes--the left being intra-abdominal and the right located in the inguinal canal with torsion--presenting with features of an acute abdomen. He was managed in a single procedure with left laparoscopic orchidopexy and right orchiectomy due to a non-salvageable ischemic testis.