In an immunological sense, B lymphocytes are the major organelle of the tonsils and adenoids. B lymphocytes account for 60% of all tonsillar lymphocytes and T lymphocytes constitute the remaining 40%. Immunoreactive lymphocytes or lymphoid cells are distributed in four different zones within the adenoids and tonsils, namely the Reticular cell epithelium, Extra follicular areas, Mantle zone and Germinal centre of follicles. Adenoids and tonsils are involved in the induction of secretion of Secretory immunity. They play a crucial role in the regulation of immunoglobulin secretion. This is of particular significance in the pre-immune maturation of infants and children. The process of antigen uptake by the tonsils and adenoids is more or less similar to that of the Payer’s patche – the intestine-associated lymphoid tissue with a very important role in the mucosal immune response – of the intestinal epithelium. In fact, one of the particularly important functions of the tonsils is the direct transport of exogenous substances to lymph-like cells, and again tonsillar crypts play a crucial role in this mechanism. These crypts not only increase the surface area of the tonsils, but they also transport antigens to the lymphoid follicles. In humans, tonsillar immunity is most active between the ages of 4 and 10 years, and in pathological states (viral infections, dysbiosis and allergies due to antimicrobial use) it can be active earlier in infancy and early childhood, i.e. before the age of 1 year to the pre-immune maturity of 3 years. After puberty, the lymphocyte ratio (T:B cells) in the tonsils decreases. In patients with prolonged recurrent tonsillitis and adenoiditis, inflammation of the epithelial cells on the surface of the tonsils and adenoids results in the shedding of immunoreactive cells and decreased antigen presentation, which are eventually replaced by stratified squamous epithelial cells. These changes in turn lead to decreased activity of the local B-cell system and ultimately to decreased antibody production by B cells. The hypertrophic adenoids begin to atrophy with increasing age. In contrast to recurrent tonsillitis, these changes are not evident in adenoid hypertrophy, and immune regulation in the adenoids remains intact. The adenoids and tonsils, as important immune organs, are subordinate to the entire mucosal immune system of the GI tract. Recent studies have shown the role of the adenoids in the ongoing immune response and that hypertrophy is influenced by viral infections, allergies, and factors including environmental factors. In summary, early and aggressive correct treatment of adenoid hypertrophy can reduce the rate of surgery. The scientific basis for the use of any immune stimulating or enhancing drugs is lacking.