Tonsillar enlargement can be physiological enlargement or pathological enlargement, the need for excision should be based on whether it meets the indications for comprehensive judgment. 1. Cases in which resection is not considered: (1) Physiological enlarged tonsils, located in the first degree to the third degree of different degrees of enlargement, the patient does not have any complaints of discomfort. (2) Acute purulent tonsillitis without recurrent disease, without obvious clinical symptoms such as sore throat and obstructive sensation in the airway can be temporarily observed and controlled by conservative treatment. (3) If it does not cause snoring or open-mouth breathing, it can be treated without surgery. 2. Consideration of resection: (1) Repeated inflammation of tonsils, tonsils produce peripheral abscess or cause nephritis, myocarditis, etc., surgical removal is recommended. (2) Enlarged tonsils produce a sense of foreign body and obstruction in the pharynx, which affects breathing, sleeping and eating. (3) When tonsil hypertrophy produces malignant changes and tumor tissue appears, tonsil removal needs to be considered. In conclusion, it is necessary to distinguish between physiologic and pathologic tonsillar enlargement and recommend whether tonsillectomy should be performed under the guidance of a medical professional.