Acute scrotal pain in a child is a urological emergency. Surgeons should be involved early and exclude torsion promptly, often by surgical exploration. This short report compares the time taken by different medical practitioners [Emergency Department (ED) doctors and surgeons] to assess children presenting to the ED with acute scrotal pain. A retrospective observational study was carried out in a district general hospital ED over a 2-year period. A total of 205 children presented with testicular pain, 48 of whom were clinically diagnosed with torsion in the ED. Surgeons reviewed patients with testicular pain quicker than ED doctors when they were referred directly from triage (P=0.019). Overall, review by a surgeon was more timely if the patient was referred directly from triage rather than after referral by the ED doctor (P<0.0001). A direct fast-track referral system to surgeons is needed in the ED to prevent unnecessary delays in definitive management of patients with testicular pain.