”My child has recurrent tonsillitis, should I cut his tonsils? My child always snores and has a runny nose, should my tonsils be cut?” This is the most common question asked by outpatients. As an immune organ, the tonsils have their own physiological functions. Especially in children, tonsils have an important protective effect on the body, and arbitrary removal of tonsils will result in loss of local immune response and even immune surveillance disorders. Therefore, the pros and cons must be weighed before tonsillectomy, and the indications must be strictly controlled. Here, we provide readers with the 2011 Clinical Practice Guidelines for Tonsillectomy in Children developed by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) as a reference. These guidelines apply to children aged 1 to 18 years who may require tonsillectomy; they do not apply to children undergoing tonsillectomy, capsulotomy, or other partial tonsillectomy, nor to children excluded from studies related to tonsillectomy because of diabetes, cardiopulmonary disease, craniofacial anomalies, congenital anomalies of the cephalofacial region, sickle cell disease, and other coagulopathies or immunodeficiency abnormalities. Preoperative evaluation 1. Close observation for recurrent throat infections is recommended if <7 throat infections occurred in the past 1 year or <5 and <3 throat infections occurred in the past 2-3 years on average, respectively. 2. Those who have medical records for each episode of sore throat and show at least one of the findings of temperature >38.3°C, cervical lymphadenitis, pus overflowing from the tonsil surface, or positive test for Streptococcus b haemolyticus may be considered for tonsillectomy if they have had at least 7 throat infections in the past 1 year, or at least 5 and 3 throat infections in the past 2 and 3 years on average, respectively, in each year to Treat recurrent throat infections. 3. Tonsillectomy is recommended for children with recurrent throat infections who do not meet the criteria in #2, but have the following (but not limited to) factors: allergy or tolerance to multiple antibiotics, periodic fever, stomatitis, pharyngitis and lymphadenitis, and a history of peri-tonsillar abscesses. 4. The referring physician should ask the caregiver of the child with sleep apnea and tonsillar hypertrophy whether the child has co-morbidities such as growth retardation, poor academic performance, enuresis, and behavioral problems that could be improved by tonsillectomy. 5. For children with abnormal polysomnography results and tonsillar hypertrophy and sleep breathing disorder, tonsillectomy should be performed to improve sleep breathing disorder. 6.After tonsillectomy, sleep breathing disorder may still persist or recur, so further treatment is needed. Intraoperative attention 1. Intraoperative intravenous doses of dexamethasone are highly recommended. 2. It is strongly recommended that prophylactic antibiotics should not be routinely given to children undergoing tonsillectomy in the perioperative period. Post-operative attention 1. Pay attention to post-tonsillectomy pain management and educate caregivers about pain management and re-evaluation of the child. 2. For physicians performing tonsillectomy, it is recommended that primary and secondary bleeding rates after tonsillectomy should be assessed at least once a year.