Purpose This study aimed to evaluate the combined role of both high resolution and Color Doppler ultrasonography (HRUS and CDUS) for the correct diagnosis of testicular torsion. Patients and methods This study was conducted on patients with acute scrotal pain or swelling referred to emergency and general surgery departments of Nizwa Hospital, Oman during January 2011-December 2013. HRUS and CDUS were done for all 180 patients. Our study included 49 patients diagnosed as torsion of the testis; 47 patients were clinically diagnosed and 2 patients with other clinical diagnosis were diagnosed by CDUS examination. Results Testicular torsion (TT) was surgically confirmed in 33 patients (18.33%) from the 180 patients who had an acute scrotum during the study period. In our study, CDUS showed sensitivity of about 84.85% (95% CI: 68.09-94.83%) while HRUS showed higher sensitivity of about 93.94% (95% CI: 79.74-99.08%). A combination of both HRUS and CDUS findings increased sensitivity to 100.00%. Conclusion Combination of HRUS and CDUS findings, increased the accuracy of ultrasonographic study for the diagnosis of testicular torsion and decreased the rate of unnecessary surgical exploration.