Objectives: The aim of this study was to determine whether the COVID-19 pandemic affected the increase in the orchiectomy rate, in boys with acute testicular torsion, compared to the pre-pandemic period. Patients and methods: The study was conducted in the period from January 2019 to December 2020. It included 119 patients from six institutions, who underwent surgery for acute testicular torsion. The study was conducted in Croatia as a multicenter retrospective study. Patients were divided into two groups. Patients operated on before the pandemic was declared (n = 68) made up the first group (pre-COVID-19) and the second group (COVID-19) consisted of patients operated on during the pandemic (n = 51). The rate of orchiectomy and the time from onset of symptoms to emergency response were the main outcomes of the study. Results: The rate of orchidectomy in the pre-pandemic period was 16.2% (11/68), and in the COVID-19 group 43.1% (22/51) (P = 0.001). Furthermore, in the pre-COVID-19 group, the median time from onset of symptoms to admission was 6 hours (IQR 3; 22), while during the pandemic this value was 14 hours (IQR 5; 48) (P = 0.007). Compared to the pre-COVID-19 period, during the COVID-19 pandemic, a higher proportion of patients waited longer than 24 hours to arrive at the emergency room (8.8% and 47%, P = 0.007). Conclusion: This study found a significantly higher rate of orchiectomy and more frequent delays in arriving at the emergency room due to acute testicular torsion during the COVID-19 pandemic. It is necessary to ensure better education of patients about emergencies, such as testicular torsion, in pandemic conditions.