Background and Aim: Testicular torsion, as a surgical emergency, could affect the endocrine and exocrine testicular functions through oxidative stress and apoptosis that could be reduced by Ginkgo biloba administration. This study demonstrates histopathological and physiological effects of ischemia/perfusion (I/R) injury to testis, and the possible protective effects of Ginkgo biloba treatment. Materials and Methods: Fifty adult male Wistar rats, weighing 180-200 grams were randomly divided into sham-operated group, Gingko biloba supplemented group, Ischemia only group, I/R group and Gingko biloba treated I/R group. Overnight fasted rats were anaesthetized by Pentobarbital (40 mg/kg B.W. i.p.), I/R was performed by left testis 720° rotation, 2 hours of ischemia was induced by a vascular clamp, thereafter, removed for 2 hours of reperfusion in I/R and treated I/R groups. Orchiectomy was performed for histopathological studies and detection of mitochondrial NAD+. Blood samples were obtained from abdominal aorta and the separated plasma was used for subsequent determination of free testosterone, FSH, TNF-α, IL1-β. Results: Values are in Mean ± SEM, compared by ANOVA. Plasma free testosterone was significantly decreased in I/R, and ischemia only groups compared to control group (30 ±11.55 vs 142.5 ±29.83, 52.5 ±10.31 vs 142.5±29.83, P<0.005, <0.01 respectively), and was significantly increased in Ginkgo biloba treated I/R group compared to I/R group (113.33 ±34.8 vs 30 ±11.55, P <0.05). Plasma FSH level was significantly elevated in I/R group compared to control group (2.12 ±0.17 vs 1.76 ±0.03, P <0.02). Plasma TNF-α, IL-1β and mitochondrial NAD+ were significantly increased in I/R group compared to control group (107.65 ±19.78 vs 35.15 ±0.51, 97.71 ±19.08 vs 59.39±0.53, 16.83±1.53 vs 6.5±1.09, P <0.001, <0.01, <0.001 respectively), and were significantly decreased in ischemia only and Gingko biloba treated I/R groups compared to I/R group (36.38 ±1.4 vs 107.65 ±19.78, 55.88 ±6.22 vs 107.65 ±19.78, 60.57 ±1.17 vs 97.71 ±19.08, 47.04 ±0.07 vs 97.71 ±19.08, 11.29 ±0.92 vs 16.83 ±1.53, 8.67 ±1.58 vs 16.83 ±1.53, P<0.001, <0.001, <0.02, <0.002, <0.01,<0.001 respectively). I/R caused marked testicular damage in addition to significant decrease in both germ and Leydig cells compared to control group, which were reversed by Ginkgo biloba treatment. Also, there was increased APAF-1 in the apoptotic cells in ischemia only and I/R groups. Conclusion: I/R caused a state of subfertility induced by apoptosis and oxidative stress that could be reduced by Gingko biloba administration alone.