Edema is the chief factor in enlargement of tonsils of children with allergic disease. In the absence of infection tonsillectomy and adenoidectomy are contraindicated in the allergic child except when obstruction is present. Infection produces one of two distinct patterns when it influences allergic states, the pattern depending upon the nature of the infectious disease. Chronic infection of the upper respiratory tract in the allergic child produces a pattern simulating that of acute respiratory infection.If, in the presence of infected tonsils and adenoids, management of the allergic state does not produce results, tonsillectomy and adenoidectomy are indicated. Management of the allergic disease must be continued postoperatively. Whether infection is present or absent, allergic disease can be controlled only through competent management of it.