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Objective: To explore the value of complete blood count (CBC), including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte lymphocyte ratio (MLR) in diagnosis of testicular torsion (TT) and differential diagnosis from epididymo-orchitis. Methods: The study was conducted at the Antalya Training and Research Hospital Emergency Department in Turkey with acute scrotal pain patients from January 1st, 2016 to January 1st, 2018. The patients were categorized into 3 groups: the TT group who underwent an operation for TT (n=70), the epididymo-orchitis group who received epididymo-orchitis treatment (n=120), and the healthy control group (n=100). NLR, PLR, and MLR of the three groups were analysed and compared. The optimum cut-off values of NLR, MLR, and PLR were analyzed. Results: Mean NLR and MLR values were significantly higher in the epididymo-orchitis group and the TT group compared to the control group (P<0.001). Receiver operating characteristic analysis revealed a sensitivity of 77.1% and a specificity of 80% for NLR (77.1) and a sensitivity of 68.2% and a specificity of 78% for PLR (124.80). Moreover, when MLR was used to differentiate the two treatment groups, the optimal cut-off value had a sensitivity of 67.1% and a specificity of 75% (AUC: 0.677-0.826, P<0.001). Conclusions: NLR, PLR, and MLR might be associated with the diagnosis of TT. These parameters provide a useful and economical method to help diagnose TT in the emergency department.