A 26-year-old woman in her first pregnancy at 18 weeks of gestation went to the emergency room with abdominal pain at left lower quadrant and inguen complicated with omitting, low fever and uterine contraction. Ultrasound showed intrauterine twin pregnancy and found a hypoecho solid mass at left adnexal area with a size of 81 mm x 59 mm x 57 mm and CDFI did not show any flow signals in or around the mass. A diagnosis of adnexal torsion was considered and an emergency laparoscopic exploration was performed. Laparoscopic view showed purple left ovary and fallopian tube with torsion and infarction. Adnexectomy of the left side was performed. The pathology diagnosis revealed extensive hemorrhage and necrosis of ovary and fallopian tubal and ovarian tissue. At 38 weeks of gestation, she delivered spontaneously two healthy infants. The aim of this video is to present a safe laparoscopic technique during mid-term pregnancy.