At the surface of the respiratory and digestive organs the organism first comes into contact nasally and orally with various foreign agents and substances in the air and in food. The palatine tonsils are located at the centre of this strategic region. Immunological processes, both humoral and cellular, are initiated in the different specialised compartments of the palatine tonsils, such as the crypt epithelium, lymphoid follicles and extrafollicular region. Each compartment has a typical composition of lymphocytes and dendritic cell subsets. This review summarises current data on the anatomy, histology, and pathology of the human palatine tonsils, describes their fundamental immunological functions, and provides insight into the various interactions involved in the initiation of immune responses. The palatine tonsil is the only easily accessible human lymphoid organ and is often taken as an example for lymphoid organs. Although affections of the palatine tonsils constitutes an essential part in the clinical routine, it is still controversial whether tonsillectomy is of general benefit. This is of increasing importance since it has been discovered in the last few years that the palatine tonsils are reservoir and replication sites of HIV.