[Abstract] OBJECTIVE: To introduce a new method of transoral approach to preserve the tonsils for stem syndrome. METHODS: We retrospectively analyzed the clinical data, surgical methods and efficacy of five cases of stem syndrome with transoral approach to preserve the tonsils in our hospital from October 2008 to October 2011. Results: All of the patients in this group had unilateral onset; all of them came to the hospital with sore throat, and two of them had ear pain, tinnitus, and foreign body sensation in the pharynx, and one of them was a female patient with insomnia and other neurotic-like syndrome. In all patients, a partial tonsillar flap with the tip at the root of the tonsil and the posterior arch was made through the oral approach, and then the stem was truncated and the tonsils were finally sutured in situ. The symptoms disappeared after more than 6 months of postoperative follow-up. Conclusion: The new method of transoral approach to stem shortening is completely possible, with less trauma, less bleeding, less postoperative reaction and quicker recovery, and the intraoperative preservation of the tonsils preserves the immune defense function of the patient and avoids pharyngeal discomfort due to pharyngeal scar contracture after removal of the tonsils.