Objective To investigate the treatment methods and efficacy observation of children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Fifty-nine children aged 4 to 12 years with OSAHS diagnosed by polysomnography (PSG) were treated with tonsillectomy and/or transoral endoscopic (endoscopic) guided adenoidal scraping in 54 cases; 2 cases were treated with continuous positive airway pressure (CPAP); 3 cases were treated conservatively; and 2 cases were treated with CPAP. There were 2 cases of long-term positive airway pressure (CPAP) and 3 cases of conservative treatment. OSAHS quality of life for children withobstructivesleep apnea 18 items (OSA-18) was used to follow up the children before and after treatment. Results No postoperative bleeding or acute respiratory obstruction occurred during the perioperative period. Follow-up from 12 to 18 months, the operated children had no complications such as nasopharyngeal atresia, pharyngeal tube dysfunction, adenoid residue, etc.; OSA-18 survey scores showed that 76.3% (45 cases) of the children’s overall quality of life indicators, 88.1% (52 cases) of the children’s sleep apnea, and 67.8% (40 cases) of the children’s physical symptoms were significantly improved after treatment. The effective therapeutic pressure of long-term CPAP treatment was around 5.6-7.8 cm H2O. Three cases of conservative treatment showed slight improvement. Conclusion Surgical removal of enlarged tonsils and/or adenoids causing upper airway obstruction is one of the effective treatments for OSAHS in children, and fiberoptic nasopharyngoscopy and lateral cephalometric radiography are helpful in determining the indication for surgery. Transoral endoscopic-guided adenoidal curettage is characterized by direct visualization, clear field of vision, thorough resection, and can avoid damage to important surrounding structures.