Tonsillar hypertrophy is mostly seen in children and adolescents, generally without obvious symptoms, we are also more common in clinical adults with tonsillar hypertrophy, some have pharyngeal discomfort, foreign body sensation, or morning nausea, irritating cough, bad breath, etc.. Tonsillar hypertrophy can cause breathing difficulties, especially during sleep, because the tongue also relaxed backwards, resulting in snoring like thunder, and over time will affect growth and development due to chronic hypoxia, chronic hypoxia will also make the child’s intellectual development is affected. With the improvement of people’s living standard, due to the modern people’s fast-paced life, the awareness of their own protection is strengthened, requiring modern treatment means in the shortest possible time, to minimize the pain, and need a satisfactory treatment results, and the operation just make up for the shortcomings of the traditional surgery, become a new generation of surgical platform in the field of soft tissue surgery. The use of microwave thermal coagulation tonsillar hypertrophy first pushed the Chinese medicine “branding method”, dating back to the Tang Dynasty Sun Simiao “Thousand Gold Wing Formula” “treatment of pharyngeal swelling, hanging flesh, …… first to the bamboo tube in the mouth, hot burning from the bamboo column, but a few degrees, healing “. In the “experience Houke Zizhenji, clinical evidence of the twenty important decisions” recorded a variety of branding methods, branding tools to beat and post-branding care. With the progress of the times, microwave therapy instead of the traditional branding method, microwaves belong to a high-frequency electromagnetic waves, with a certain energy and penetration, when the probe emits microwaves, contact with tonsil tissue can produce instant high temperature, up to about 60 degrees Celsius, so that the tonsil surface internal tissue quickly heat, protein coagulation denaturation, denaturing tissue in a short period of time due to inactivation and natural fall off, the lesion tissue disappears permanently. Microwave is a wavelength of electromagnetic waves in the range of 1mm-1m, its frequency between high-frequency electricity and laser, clinical use of common bio-thermal effect, the difference is that high-frequency electricity and laser is through the form of heat conduction to heat the tissue, belonging to the external heating, so the temperature is high, so that the tissue charring. Microwave therapy instrument produces an electromagnetic wave, is the biological tissue itself as a heat source inward heating, so that tissue denaturation, coagulation, necrosis, line coagulation of its tissue capillaries and small arteries, small veins closed, so it is not easy to bleed, women can still be treated during menstruation, reducing the risk of conventional surgery bleeding; at the same time, because it is the biological tissue itself as a heat source, not easy to spread to the surrounding, in the same radiation In the same radiation field, the surface of the tissue and the internal damage is the same depth, so that the tissue is instantly coagulated from inside to outside, the temperature is low, the boundary of the damaged area is clear, and the heating is uniform, with good hemostatic effect, no charring, no smoke, and good safety, unlike laser which is heavy on the surface damage and easy to injure the surrounding tissues; in addition, the device is low cost, simple operation, and short treatment time, which facilitates outpatient treatment and reduces patients’ medical expenses; the intraoperative and postoperative pain is less than that of traditional surgery. At the same time, the heat generated by the thermal effect of microwave has a certain bactericidal effect, which is not easy to scab infection; more importantly, it removes the hypertrophic tonsils without bleeding, so that the tonsils still partially exist and play its proper physiological function. Of course, it has certain limitations and cannot replace traditional surgery. The chronic inflammation of tonsils causing hypertrophy with recurrent acute onset should still be removed traditionally, because microwave can only make it smaller and cannot completely eliminate inflammation. On the contrary, it can close the crypt, resulting in the possibility of postoperative tonsil storage cyst formation. However, the coagulation should not be excessive, the radiation needle insertion should not be too deep, the distance from the tonsil tissue should be certain, the time should not be too long, and the radiation energy should not be too high, so as not to damage the adjacent muscle tissues such as the tongue and palate muscles, the pharyngeal and palatal sail muscles. At the same time, it is not required to reach the normal level completely during the operation. If the effect is not satisfactory in 3 months after the operation, thermal coagulation can be performed again to avoid too much damage resulting in too much dry scab formation, which can cause secondary bleeding. This surgical treatment has the characteristics of precision, low temperature, rapid hemostasis, small trauma, as well as light postoperative pain response and quick recovery. The procedure is easy to perform, especially for patients with hypertension and diabetes, and provides an effective treatment option for some patients who previously could not tolerate the procedure and can be repeated. The operation is completely under the control of the physician’s field of vision, always keeping the operative field clear, the anatomical levels well defined, and the safety performance is good. However, case selection is also very important, and tonsil removal is still routinely performed for unilateral tonsillar hypertrophy, tonsillar ulcers, and tonsillar neoplasia.