The indications for pediatric adenotonsillectomy have changed over time from chronic pharyngitis to sleep-disordered breathing. It is important to thoroughly evaluate children for symptoms related to these problems. Symptoms of sleep-disordered breathing range from snoring to obstructive events. Diagnosis is made from accurate history taking, physical examination, and polysomnography. Although surgical treatment has been shown to improve the quality of life in these children, it is not without risks, including bleeding, velopharyngeal insufficiency or postobstructive pulmonary edema. (c) 2007 S. Karger AG, Basel.