Tonsillectomy: Procedure, Recovery Timeline and Risks Explained
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is a tonsillectomy?
A tonsillectomy is surgery to remove the two tonsils at the back of the throat, usually done under general anesthesia as a same-day procedure lasting about 20 to 30 minutes. It mainly treats sleep-related breathing problems such as sleep apnea and frequent tonsillitis. Most people recover in about two weeks; call a provider for any bleeding or breathing trouble. [1]
What the research says
Early surgery improved sleep in children with sleep apnea. In a randomized trial of 464 children aged 5 to 9 with obstructive sleep apnea, sleep-study results returned to normal in 79% of children after early adenotonsillectomy, compared with 46% of children managed with watchful waiting. Symptoms, behavior and quality of life also improved more after surgery, although attention test scores did not differ between groups. (Marcus et al., N Engl J Med, 2013) [2]
Adults with repeated tonsillitis had about half the sore-throat days after surgery. In a trial of 453 adults, those who had tonsillectomy reported a median of 23 sore-throat days over two years versus 30 days with non-surgical care (adjusted rate ratio 0.53). Bleeding was the most common side effect, affecting 19% of surgical patients. (Wilson et al., Lancet, 2023) [3]
In children, the benefit for sore throats is real but modest. A review of five trials in 987 children found an average of 3 sore-throat episodes in the first year after surgery versus 3.6 without surgery, and one of those 3 episodes was the expected sore throat right after the operation. (Burton et al., Cochrane Database Syst Rev, 2014) [4]
Key takeaways
A tonsillectomy removes both tonsils, the round, fleshy masses on each side of the back of the throat. [1]
The two main reasons for surgery are breathing-related sleep disorders (like sleep apnea) and frequent or chronic tonsillitis. [1]
The operation usually takes 20 to 30 minutes, and most people go home the same day. [1]
Full recovery takes about two weeks, and sore throat often peaks around day 3 or 4. [1]
Removing the tonsils does not weaken the immune system. [1]
What is a tonsillectomy?
A tonsillectomy (tahn-suh-LEK-tuh-me) is surgery to remove your tonsils, the two round, fleshy masses at the back of your throat. You have one on each side, and they are part of your immune system. [1]
Tonsils can become inflamed and cause painful sore throats. They can also swell and block part of the airway, which can make breathing harder during sleep. [1]
Children need this surgery more often than adults. Tonsils grow bigger during childhood and can shrink with age, which is why tonsil problems are more common in kids. [1]
Although surgeons perform fewer tonsillectomies than in the past, it remains a common operation today. [1]
A tonsillectomy removes both tonsils under general anesthesia.
Why is a tonsillectomy done?
A tonsillectomy is done for two main reasons: to treat breathing-related sleep disorders and to reduce infections in people with frequent or chronic tonsillitis. [1]
Reason for surgery | What it means |
Sleep-related breathing problems | Enlarged tonsils narrow the airway during sleep, as in obstructive sleep apnea |
Frequent or chronic tonsillitis | Repeated tonsil infections that keep coming back |
Until the 1980s, most tonsillectomies were done for tonsillitis. Today, sleep apnea is the more common reason. [1]
If your child snores or seems to stop breathing at night, our guide to obstructive sleep apnea in children explains the warning signs and next steps.
What is the 7-5-3 rule for tonsillectomy?
The 7-5-3 rule, also called the Paradise criteria, helps healthcare providers decide whether a child with tonsillitis may benefit from surgery. It is named after the pediatrician who developed it. [1]
A child may be a good candidate if any one of these applies:
Number of tonsillitis episodes | Time period |
At least 7 | In the past year |
At least 5 | In each of the past 2 years |
At least 3 | In each of the past 3 years |
How do you prepare for a tonsillectomy?
Preparing for a tonsillectomy starts with a health check to confirm you are fit for surgery, which may include blood tests. [1]
Your provider will then give you instructions. These may include:
Stopping certain medicines several days before surgery
Not eating or drinking (fasting) the night before
Follow these instructions closely. [1] Our guide to anesthesia explains what general anesthesia involves.
What happens during a tonsillectomy?
During a tonsillectomy, you receive general anesthesia so you are asleep and feel no pain, and the surgeon then removes your tonsils. [1]
Surgeons can use several methods:
Method | How it works |
Electrocautery | Uses heat to remove the tonsils and stop bleeding |
Microdebrider | Uses a powered rotating shaver to remove part of the tonsils |
Coblation | Uses radiofrequency energy and a plasma field to remove all or part of the tonsils |
How long does a tonsillectomy take?
A tonsillectomy usually takes about 20 to 30 minutes, although some cases take longer. [1]
Some children also need their adenoids removed. Like tonsils, adenoids can swell. Surgeons often remove both in the same operation, which adds to the total surgery time. [1]
What are the benefits of a tonsillectomy?
The main benefits of a tonsillectomy are better sleep quality, fewer infections and improved quality of life. [1]
What are the risks of a tonsillectomy?
Complications after a tonsillectomy are rare, but they can happen. [1] Possible risks include:
Heavy bleeding during or after surgery
Swelling of the tongue or the roof of the mouth
Infection of the surgical wound
A reaction to anesthesia
Changes in your sense of taste
Dehydration
Needing more procedures
Injury to the lips, tongue or teeth
What happens right after a tonsillectomy?
Right after a tonsillectomy, you move to a recovery area where your care team checks your vital signs and watches for complications. [1]
Tonsillectomy is usually an outpatient procedure, so most people go home the same day. If a complication occurs, your provider may keep you in the hospital overnight. [1]
How long is tonsillectomy recovery?
Most people fully recover from a tonsillectomy in about two weeks. [1] Your recovery time depends on the surgical method used, how quickly your body heals and whether you have any complications. [1]
Time after surgery | What to expect |
Days 1–2 | Throat pain, low-grade fever, tiredness, bad breath, hoarse voice or trouble speaking, a feeling of fullness in the throat from swelling |
Days 3–5 | Ongoing sore throat that may get worse around day 3 or 4, tiredness |
Days 5–10 | Scabs form where the tonsils were |
About 2 weeks | Full recovery for most people |
Healing looks a little different for everyone, but this is the typical course.
How painful is a tonsillectomy?
Pain and discomfort after a tonsillectomy are normal and usually improve within one to two weeks. Recovery is generally harder for adults than for children. Your provider will give you medicine and instructions to ease the pain. Codeine and tramadol must not be given to children after tonsillectomy because they can cause dangerously slowed breathing. [1]
What can you eat after a tonsillectomy?
After a tonsillectomy, drinking plenty of fluids and eating soft, cool foods for the first week are key to healing well. [1] You can move to solid foods once you feel comfortable. Avoid crunchy and spicy foods, because they can irritate the surgical area. [1]
Good choices | Avoid |
Water, tea and juice | Crunchy foods |
Ice cream, smoothies, yogurt, pudding | Spicy foods |
Applesauce, broth | |
Mashed potatoes, scrambled eggs |
When can you go back to work or school after a tonsillectomy?
Plan to take at least 10 days off work or school after a tonsillectomy. Staying home lowers your risk of catching a cold or another infection while you heal. [1]
When should you call a doctor after a tonsillectomy?
Call your healthcare provider after a tonsillectomy if you notice any of these signs: [1]
Bleeding
Difficulty breathing
Pain that gets worse after five days or does not improve with pain medicine
Nausea and vomiting
Signs of dehydration
A fever above 101°F (38.3°C) that does not improve with medicine
Contact your provider right away if any of these appear during recovery.
Does removing your tonsils weaken your immune system?
Removing your tonsils does not weaken your immune system, and your body can still fight off germs. [1] However, the tissues in your throat can still become infected and sore after a tonsillectomy, so you can still get a sore throat or chronic pharyngitis. [1]
Conclusion
A tonsillectomy is a short, common surgery that removes the tonsils to treat sleep-related breathing problems or frequent tonsillitis. Most people go home the same day and recover in about two weeks, with the sore throat often peaking around day 3 or 4. Fluids, soft and cool foods, and at least 10 days of rest make recovery smoother. [1]
Sometimes medical treatment is all that's needed for enlarged or infected tonsils. If it isn't helping enough, removing the tonsils may be the right next step. [1]
Next step: If you or your child has repeated tonsil infections, loud snoring or pauses in breathing during sleep, talk to a healthcare provider about whether a tonsillectomy makes sense. To learn more first, read our guides to tonsillitis, pediatric sleep apnea and tonsil stones.
FAQ
What is a tonsillectomy?
A tonsillectomy is surgery to remove the tonsils, the two round, fleshy masses on each side of the back of the throat. It is done under general anesthesia and is more common in children than in adults.
Why would someone need a tonsillectomy?
A tonsillectomy is mainly recommended to treat breathing-related sleep disorders such as sleep apnea, or to reduce infections in people with frequent or chronic tonsillitis. Today, sleep apnea is the more common reason.
How long does tonsillectomy recovery take?
Tonsillectomy recovery takes about two weeks for most people. Sore throat often gets worse around day 3 or 4, and scabs form where the tonsils were between days 5 and 10.
What is the 7-5-3 rule for tonsillectomy?
The 7-5-3 rule is a guide providers use to decide whether a child with tonsillitis may need surgery. A child may qualify after at least 7 episodes in the past year, at least 5 in each of the past 2 years, or at least 3 in each of the past 3 years.
Is a tonsillectomy more painful for adults?
A tonsillectomy is generally harder to recover from for adults than for children. Pain usually improves within one to two weeks, and your provider will give you medicine to ease it.
What should I eat after a tonsillectomy?
After a tonsillectomy, drink plenty of fluids and eat soft, cool foods such as ice cream, yogurt, smoothies, applesauce, broth and mashed potatoes for the first week. Avoid crunchy and spicy foods because they can irritate the surgical area.
When should I call a doctor after a tonsillectomy?
Call your healthcare provider after a tonsillectomy if you have bleeding, difficulty breathing, nausea and vomiting, or signs of dehydration. Also call for pain that worsens after five days or a fever above 101°F (38.3°C) that does not improve with medicine.
Does a tonsillectomy weaken the immune system?
A tonsillectomy does not weaken the immune system, and the body can still fight off germs. The throat can still become infected and sore after the tonsils are removed.
Is bleeding normal after a tonsillectomy?
A few specks of blood in saliva can happen, but bright red blood or spitting up blood is not normal. Call your surgeon right away for any bleeding, and call 911 or go to the emergency room if bleeding is heavy.
Why does my ear hurt after a tonsillectomy?
Ear pain is common after a tonsillectomy because the throat and ears share nerves. This pain usually fades as the throat heals.
Related Reading
Adenoidectomy (Adenoid Removal): Surgery and Recovery explains adenoid removal surgery in children.
References
Cleveland Clinic. Tonsillectomy: Procedure Details & Recovery. Cleveland Clinic. Last updated December 8, 2025. https://my.clevelandclinic.org/health/treatments/15605-tonsillectomy
Marcus CL, Moore RH, Rosen CL, et al. A randomized trial of adenotonsillectomy for childhood sleep apnea. N Engl J Med. 2013;368(25):2366-2376. PMID 23692173. https://doi.org/10.1056/NEJMoa1215881
Wilson JA, O'Hara J, Fouweather T, et al. Conservative management versus tonsillectomy in adults with recurrent acute tonsillitis in the UK (NATTINA): a multicentre, open-label, randomised controlled trial. Lancet. 2023;401(10393):2051-2059. PMID 37209706. https://doi.org/10.1016/S0140-6736(23)00519-6
Burton MJ, Glasziou PP, Chong LY, et al. Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev. 2014;2014(11):CD001802. PMID 25407135. https://doi.org/10.1002/14651858.CD001802.pub3
Disclaimer
This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always talk to a qualified healthcare provider about your health or your child's health. If you have heavy bleeding or trouble breathing after surgery, seek emergency care right away.
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