In the pediatric asthma clinic, we often encounter parents of children asking about “adenoid hypertrophy”, and the most common question is about “surgical treatment”. Secondly, it should be noted that “adenoid hypertrophy” may be a concomitant problem of childhood asthma and allergic rhinitis, and with standard treatment of childhood asthma and allergic rhinitis, adenoid hypertrophy can sometimes return to normal. Therefore, the treatment of adenoid hypertrophy in children should be “observation, waiting, and adequate medication”, and only if these measures do not work, or if the health is already seriously affected, surgery is an option. Adenoids are an important part of the inner ring of the pharyngeal lymphatic ring, which is hidden in the back of the nasal cavity and is the lymphatic tissue at the top of the nasopharynx, and they exist after birth and proliferate with age, becoming largest around the age of 6 and gradually degenerating later. Adenoid hypertrophy in children is mostly a physiological phenomenon, and the general adenoid hypertrophy is not very dangerous to children’s health, but if children repeatedly suffer from upper respiratory tract infections, the adenoids are repeatedly stimulated by inflammation and pathological hyperplasia occurs. When the adenoids become enlarged, they block the upper respiratory tract and cause nasal congestion, open-mouth breathing, snoring, and restless sleep, and children often turn over from time to time, more obviously when lying on their backs. Adenoid hypertrophy can cause airway narrowing, making the oxygen saturation in the blood insufficient, the brain is in a state of chronic and continuous hypoxia, the child is drowsy during the day, poor mental health, memory loss, and decreased academic performance. Long-term nasal congestion and poor breathing can also affect heart and lung function, and in serious cases, it can cause pulmonary heart disease, damage to the heart muscle, and even right ventricular heart failure. We once treated a child with asthma combined with allergic rhinitis, whose adenoids had completely compressed the airway and caused right ventricular hypertrophy due to chronic hypoxia, and had been treated as “cardiomyopathy” in an outside hospital for a long time. In children with allergic rhinitis, the inflammatory secretions backflowing from the nasal cavity stimulate the adenoids to enlarge, therefore, adenoid hypertrophy and allergic rhinitis and asthma often coexist, and good control of rhinitis and asthma can reduce the degree of adenoid hypertrophy. Similarly, if adenoid hypertrophy is caused by allergic rhinitis and asthma, although surgical treatment is chosen, the cause is not eliminated because the allergic rhinitis and asthma are not well treated, and the disease may recur later. For “mild to moderate” adenoid hypertrophy (no more than 70% of the airway is compressed), medication can be given as a nasal spray of surface corticosteroids or combined with leukotriene antagonists or antihistamines. Severe hypertrophy that has affected the growth and development of the child should be surgically removed, and postoperative treatment of allergic rhinitis and asthma should also be emphasized.