The tonsils are a mass of lymphatic tissue under the epithelium of the oropharynx, and are called palatine tonsils, pharyngeal tonsils, and lingual tonsils, respectively, according to their location. The palatine tonsils are the largest and are commonly referred to as the tonsils. There is a pair of tonsils, located between the lingual and palatal arches and the pharyngeal and palatal arches, which are oval in shape and covered by squamous epithelium. The epithelium sinks into the interior of the tonsils to form 10 to 20 crypt foci, which contain shed epithelial cells, lymphocytes and bacteria. The tonsils are a defense organ of the body and produce lymphocytes and antibodies, which have an immune defense function against bacteria and viruses. However, tonsils are also susceptible to bacterial and viral infections and inflammation, causing symptoms such as fever, cough and sore throat, and even leading to complications such as rheumatic fever and acute nephritis. Tonsillitis is mainly an infectious inflammation of the tonsils, which can be divided into acute tonsillitis and chronic tonsillitis. Acute tonsillitis is mostly caused by bacterial or viral infection when the body’s resistance is lowered, and it starts rapidly with symptoms such as sore throat, cough, fever and headache. Acute tonsillitis is mostly caused by bacterial or viral infections. When acute tonsillitis is caused by a virus, the symptoms are mild, with red and swollen tonsils, fever and cough. In acute tonsillitis caused by bacteria, the child usually has a sudden onset of high fever with a temperature of 39 to 40°C, severe throat pain, marked redness and swelling of the tonsils, sometimes swollen lymph nodes in the neck, and increased white blood cells in the blood test. Acute tonsillitis in children can cause complications such as otitis media, rhinosinusitis, pneumonia, etc. In the case of streptococcal tonsillitis, rheumatic fever and nephritis can be combined. In acute purulent tonsillitis, the onset of the disease is acute, with persistent high fever, severe systemic symptoms, chills, decreased appetite, enlarged lymph nodes in the jaw angle, and even high fever and alarm. On examination, the tonsils are obviously enlarged, congested, and have pus moss on the surface. When the tonsils are purulent in the parenchyma, the surface of the tonsils is yellowish-white protruding. The main reason for this is that it is not a good idea to have an acute tonsillitis or a recurring infection due to poor drainage of the tonsillar fossa, which can be acute whenever you get cold or flu. Chronic tonsillitis is mainly caused by recurrent acute tonsillitis, which is manifested by frequent other discomfort in the pharynx, foreign body sensation, dry and itchy hair, irritating cough, bad breath and other symptoms. Excessive tonsillar hypertrophy can cause respiratory and swallowing language disorders, due to frequent swallowing of secretions and bacterial toxins in the crypt can cause indigestion, headache, fatigue, low fever and other symptoms of speech. Pediatric tonsils usually begin to develop at the age of 1 year, and the peak of development is from 4 to 10 years old, so children within 1 year of age have less tonsillitis. Tonsils belong to the lymphatic tissue. Since the lymphatic system of children is highly developed and the immune system is not well developed, they are easily infected by various pathogenic microorganisms, therefore, children are prone to tonsillitis. As the human lymphatic system develops and perfects, the tonsils gradually shrink during adolescence and inflammation decreases significantly. The main treatment for acute tonsillitis is to control the infection. Tonsillitis is mostly a bacterial infection, especially purulent tonsillitis is the result of a clear bacterial infection, so it must be treated with antibiotics. Purulent tonsillitis, mostly caused by Streptococcus pneumoniae or Staphylococcus aureus, should be treated with intravenous antibiotics of choice. As most of the bacteria causing purulent tonsillitis are resistant to penicillin, cephalosporins (1st or 2nd generation) should be preferred and should be treated for a full course of 5 to 7 days, while still using the same kind of drugs as intravenous drugs after discontinuation of oral medication. Even if the choice of sensitive antibiotics sometimes in the treatment of 3 to 5 days before the temperature fell, it is important not to prematurely change the drug and stop. If the acute attack of chronic tonsillitis should be given anti-infective treatment, if the tonsils are enlarged causing breathing difficulties, sleep disturbance, snoring, surgery can be considered, otherwise the child will affect physical and intellectual development. The tonsils are the gateway to the respiratory tract and have certain immune functions that prevent some diseases from occurring. Pediatric tonsillar hypertrophy is a normal physiological phenomenon. If the hypertrophy does not affect breathing and swallowing and does not produce heavier clinical manifestations, it should not be removed. Removal of the tonsils may affect the local immune response and reduce the body’s ability to fight infection. However, surgical removal is required if the tonsils are frequently inflamed, with 3 to 4 episodes per year, or if they form an obstruction in the upper respiratory tract caused by, for example, chronic tonsillitis, resulting in severe snoring, poor swallowing, slurred pronunciation, or if they affect the child’s physical and intellectual development. Generally, tonsillectomy for children should be performed after the age of 4, and it is more appropriate to remove them 2 to 3 weeks after the inflammation subsides. Tonsil removal will not affect the child’s health because tonsils are a developing organ that gradually atrophies after the age of 10, and the immune function of tonsils basically disappears after the age of 12.