Objective <p>This study aims to retrospectively analyze the clinical data of neonates with Neonatal Testicular Torsion (NTT) treated at our center, explore its clinical characteristics, and summarize our clinical experience.</p> Methods <p>A retrospective analysis was conducted on the clinical data of 30 neonates diagnosed with NTT and treated at our hospital between August 2010 and August 2023.</p> Results <p>A total of 30 NTT cases were included in this study, with one case of bilateral synchronous NTT and the rest being unilateral NTT. The median gestational age was 39 weeks (IQR: 38, 40), and the mean birth weight was 3.39 ± 0.45&#xa0;kg. Of the 30 neonates, 26 (86.7%) were full-term (&gt; 37 weeks gestation), and 4 (13.3%) were preterm. 17 (56.7%) were born vaginally, and 13 (43.3%) were delivered via cesarean section. The median age at presentation was 48&#xa0;h (IQR: 24, 138), and the median time from symptom onset to surgery was 24&#xa0;h (IQR: 11.25, 72.00). Clinical symptoms included abnormal scrotal color (80%), scrotal enlargement (63.3%), and nausea/vomiting (6.67%). Preoperative ultrasound in all cases suggested testicular torsion and confirmed the diagnosis, followed by emergency surgery. All patients, including the case of bilateral synchronous NTT, underwent testicular removal and fixation of the contralateral testis. Postoperative follow-up ranged from 6 to 36 months, with 2 cases lost to follow-up. One patient with bilateral testicular removal was followed by the endocrinology department, and the remaining 27 patients showed normal development of the contralateral testis.</p> Conclusion <p>NTT is clinically rare and lacks specific symptoms, making it prone to misdiagnosis or missed diagnosis, leading to a high rate of testicular loss. Medical staff should be highly alert to the possibility of NTT when neonates present with scrotal swelling and color changes, ensuring timely diagnosis and treatment.</p>