We present our experiences with the pathology of the spermatic cord: 39 newborns and children of the 1st life month with acute scrotum syndrome in last 12 years. We have analyzed the efficacy of diagnostics, surgical treatment, the causes of the unsatisfactory results and possible solutions. We discuss the characteristic signs of the testicular torsion in the newborn age, the difficulties of the diagnosis and consequent treatment. The diagnostic standard is sonography with dopplerography, the same as in the elder patients. Differential diagnosis of torsion and thrombosis of the spermatic cord veins is complicated due to the possible misinterpretation: the blood flow is weak, the vessels are small. Therefore the constellation of clinical signs and sonography in shortest time would be decisive, sonography itself should not be considered as the “gold” standard. The peculiarities of the testicular torsion itself and causes for the poorer outcomes are analyzed. To date the organ-sparing interventions are carried out only in approximately 22%. Spermatic cord veins’ thrombosis is analyzed with regard to the causes; prophylaxis is discussed. The former should be concerned as the transitory neonatal disturbances of the hemostasis, which should be an aim for prophylactic and treatment manipulations. Otherwise it would lead to the irreversible damage to the testis.