The adenoids of 23 children (12 with secretory otitis media and 11 without S.O.M. who had tonsillitis or sore throats) were submitted for histopathology. All specimens showed the usual adenoid pattern with no differences in activity. The adenoids of 15 children (6 with secretory otitis media and 9 without S.O.M. who had tonsillitis or sore throats) were examined for viruses. They were all negative. The adenoids of 37 children (13 with secretory otitis media and 24 without S.O.M. who had tonsillitis or sore throats) were examined for bacterial micro-organisms. In the adenoids of the 13 children with secretory otitis media pathogenic bacteria were isolated in 6 instances, while in the 24 adenoid specimens of children without secretory otitis media pathogenic bacteria were isolated on only 3 occasions. On only one occasion was Candida albicans isolated. It is concluded that adenoids should be removed in children with secretory otitis media, but not during routine removal of tonsils in children presenting with tonsillitis or sore throats.