The authoritative American Academy of Otolaryngology-Head and Neck Surgery recently published “Clinical Guidelines for the Management of Pediatric Tonsillectomy”, which provides evidence-based recommendations on the indications, medications and postoperative bleeding for children aged 1-18 years who are ready to undergo tonsillectomy (with or without adenoidectomy). The recommendations are “recommended”, “not recommended” or “optional” to optimize the perioperative management. Under continuous antigenic stimulation, tonsillar lymphocytes are overwhelmed and they fail to respond to other antigens, in which case the tonsils no longer play a local protective role and do not properly strengthen the secretory immune system of the upper respiratory tract. Currently, there are no studies showing clinically significant effects of tonsillectomy on the immune system.