Throat Conditions

When Do You Need a Tonsillectomy as an Adult?

Written by Frank Schwalbe, MD | Reviewed by Farzon A. Nahvi, MD

Updated on May 15, 2026

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Key takeaways:

Tonsillectomy is a common surgery for children, but some adults need it too. Though adults experience more complications, it’s still a very safe procedure.
You may need your tonsils removed as an adult if they’re too big or if you have trouble breathing when sleeping.
Common reasons for tonsillectomy in adults include frequent throat infections, sleep apnea, and tonsil cancer.

Like most people, you’ve probably had a sore throat at some point. Behind the scenes, your tonsils were likely hard at work. The tonsils are a special tissue in the back of your throat that help fight infection. Usually, that sore throat goes away in a few days after you rest and drink plenty of fluids. But tonsillitis can occur when there’s infection or inflammation of the tonsils.

If you get frequent tonsillitis as an adult, you may need to visit a healthcare professional to see if you need a tonsillectomy. Let’s take a closer look at signs you need your tonsils removed as an adult and what you can expect before, during, and after the procedure.

What is a tonsillectomy?

A tonsillectomy is a surgery to remove the tonsils. Both children and adults can get it. In the U.S., it’s one of the most common surgical procedures. Over half a million children under the age of 15 have their tonsils removed each year.

What are signs and symptoms of tonsillitis?

When the tonsils are infected or inflamed, you may notice several changes. You can expect to see these symptoms of tonsillitis:

Enlarged, red tonsils
Pain with swallowing
White spots on the tonsils
Painful lymph nodes in the neck

In addition to throat symptoms, you may also notice related symptoms such as:

Fever
Headache
Stomach pain
Ear pain
Difficulty breathing while sleeping

Why do you need a tonsillectomy in adulthood?

A healthcare professional may recommend a tonsillectomy if your tonsils stay too big for a long time. This can be due to a number of conditions affecting the tonsils. Let’s review some of the more common reasons for tonsillectomy in adulthood.

Frequent strep throat infections

Tonsillectomy may be an option if you have more than six sore throats in a year and any of the following:

Fever
Swollen lymph nodes
Positive strep tests

You may also consider a tonsillectomy if you have:

Five or more sore throats in each of the past 2 years
Three or more sore throats in each of the past 3 years

In these cases, the procedure may help to reduce frequent throat infections.

Peritonsillar abscess

A peritonsillar abscess is a pocket of pus near a tonsil. It’s a common complication of tonsillitis, but dental infections can also cause it.

Symptoms of peritonsillar abscess are similar to tonsillitis, but you may notice severe throat pain on just one side.

A healthcare professional can drain a peritonsillar abscess. But they may recommend a tonsillectomy if you have recurrent throat infections.

Sleep apnea

Sometimes, tonsils get so big that they can block off part of your airway during sleep. This is what happens in sleep apnea. Adults who have sleep apnea often have enlarged tonsils.

If you snore and have big tonsils, your healthcare team may recommend a sleep study. This test shows how well you breathe while you sleep. Depending on the results, you may need a tonsillectomy.

Tonsil cancer

Tonsil cancer is the most common type of throat cancer. Experts note that it’s being diagnosed more often — likely due to rising rates of human papillomavirus (HPV) infection. Other risk factors for developing tonsil cancer include smoking and alcohol use.

Cancer in the tonsils sometimes has no symptoms. When symptoms of tonsil cancer are present, they may include:

Sore throat
Ear pain on one side
Enlarged tonsil on one side
Sensation of a something in the throat
A feeling that the jaw is stuck open
Swollen lymph nodes

Treating tonsil cancer may involve removing the tonsils, neck lymph nodes, and part of the throat. Radiotherapy, chemotherapy, and immunotherapy may also be a part of the treatment plan.

What are the risks and complications of tonsil removal in adults?

While all surgery has some risk, tonsillectomy is a very common procedure. Adults have a higher rate of complications than children do, but it’s still very safe. Pain is common, and it can be severe in adults.

In adults, there’s also an increased risk of pneumonia and urinary tract infections (UTIs) for up to 30 days after surgery. This isn’t a direct complication of removing the tonsils. It’s more likely due to underlying health conditions that are more common in adults than in kids.

Some of the biggest risks include complications related to:

Anesthesia: It’s possible to have nausea or vomiting after anesthesia.
Bleeding: Some bleeding after tonsillectomy is normal. But excessive bleeding can be serious. Most bleeding happens within a day of surgery, but it can happen up to 2 weeks after the procedure.
Pain: This is the most common complication. Pain can last for up to 2 weeks as the tissue heals.
Dehydration: Pain can make it difficult to swallow, so you may drink much less fluid than your body needs. The best way to prevent dehydration is to manage your pain. This lets you drink as much fluid as your body needs each day.
Voice changes: Rarely, surgery can cause too much air to reach the nasal passages when you talk. The result is a nasal-sounding voice that’s difficult to understand. This usually gets better on its own within several months, but sometimes people need surgery.

What’s the recovery time from a tonsillectomy for adults?

The recovery time from a tonsillectomy for adults is about 2 weeks. Exactly how long it takes you to recover will depend on factors like your overall health and the type of tonsillectomy you had. Your healthcare team will recommend that you take it easy and limit strenuous activity for a couple of weeks. It’ll take your body that long to heal completely.

Tonsillectomy recovery looks a bit different for everyone. Here are some general recovery stages and patterns to expect.

Tonsillectomy recovery stages

The first 3 days after tonsil removal tend to be the hardest. In the first few days, you may experience:

Throat and ear pain
Tiredness
Difficulty speaking and swallowing
Bad breath
Mild fever (under 101°F)

Good to know: You’ll likely feel better right after you get home from surgery than the day after. Days 2 to 4 are often the most challenging days. This is when the pain medication from the surgery has worn off.
A week or so after your tonsillectomy, you may notice white patches in your throat. This is from scabbing, which is a normal and expected part of the healing process. As the patches naturally come off, you may notice a small amount of bloody mucus.

What follow-up care do you need after a tonsillectomy?

Your healthcare team will give you specific instructions after your tonsillectomy. It’s important to follow them to help prevent any complications from the surgery. Your instructions will likely include information about:

Pain management: Your healthcare team will likely recommend certain medications for pain and give you a specific schedule so you know how often to take them.
Hydration: Make sure to stay hydrated by drinking plenty of liquids. This will help prevent constipation. It’ll be easier to drink (and swallow) fluids if you stay ahead of your pain.
A soft diet: If you’re wondering what to eat, start off with foods that are easy to swallow, like ice cream, broth, Jell-O, or pudding. Avoid trying to swallow solid foods for several days after surgery.
Oral hygiene: Brush your teeth at least twice a day, and gargle with water each time you eat. This helps to keep the wound clean and decreases your risk of wound infection. It also helps to improve the bad breath that can come with surgery.

Frequently asked questions

Having your tonsils removed may have positive long-term effects on your quality of life. But any surgery has possible complications, and researchers are still investigating how tonsillectomy affects overall health in the long term.

One study found that children who had their tonsils removed had higher rates of allergic, infectious, and respiratory conditions later in life compared to children who didn’t have a tonsillectomy. If you’re unsure whether tonsillectomy is right for you, your care team can help you weigh the pros and cons and understand your options.

Tonsil removal for adults is usually not the first-choice option. The specific alternatives to tonsillectomy depend on what’s causing the problem. For example, many adults with sleep apnea have enlarged tonsils. There are a range of treatment options for sleep apnea, including a CPAP machine, different surgeries, and oral devices. Your healthcare team will review your options with you and help you figure out the best approach.

There’s really no specific age when it’s “too late” to remove your tonsils. Tonsillectomy is more common in children than adults. But, as we reviewed above, there are times when tonsil removal is appropriate for adults. An ENT (ear, nose, and throat) specialist can help you understand your options.

The bottom line

Tonsillectomy is a common procedure to remove enlarged tonsils in adults. Your healthcare team may suggest having your tonsils removed if you have problems like recurrent infections or sleep apnea. Pain is common while recovering from a tonsillectomy as an adult. Overall, it’s a very safe procedure for adults, and most serious complications are rare.

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Written by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Farzon A. Nahvi, MD

Farzon Nahvi, MD, is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works at Concord Hospital in Concord, New Hampshire, and teaches at the Geisel School of Medicine at Dartmouth.

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References

Byars, S. G., et al. (2018). Association of long-term risk of respiratory, allergic, and infectious diseases with removal of adenoids and tonsils in childhood. JAMA Otolaryngology Head & Neck Surgery.

Chen, M. M., et al. (2014). Safety of adult tonsillectomy: A population-level analysis of 5968 patients. JAMA Otolaryngology Head & Neck Surgery.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

When Do You Need a Tonsillectomy as an Adult?

Key takeaways:

What is a tonsillectomy?

What are signs and symptoms of tonsillitis?