If the second-degree enlargement of the tonsils occurs in childhood, it is a physiological enlargement of the tonsils and has the potential to gradually shrink on its own as it ages. However, if the patient is an adult, it basically will not shrink. The tonsils are an immune organ and act as the first line of defense when bacteria and viruses invade, and an inflammatory response occurs. If the tonsils are repeatedly inflamed it can lead to enlargement of the tonsils. Second degree enlargement is when the tonsils exceed the lingual-palatal arch, but not the pharyngopalatal arch. If second-degree tonsillar enlargement occurs in childhood, the enlarged tonsils can gradually shrink and recover on their own by controlling the recurrent inflammation of the tonsils. However, if the swelling occurs in adults, the swollen tonsils may not heal on their own because it is difficult to completely reduce the swelling and there is a possibility of recurrent inflammation of the tonsils. Patients with second-degree tonsillar enlargement can be left alone and observed if they do not have symptoms such as pain in the pharynx, foreign body sensation in the pharynx, snoring and breath-holding during sleep, or obstruction during swallowing. If the patient has the above symptoms, which affect the breathing, swallowing and pronunciation functions, surgery to remove the tonsils should be considered.