Abstract Objectives To analyse operating time, intraoperative blood loss, postoperative bleeding rate and pain when using the relatively new BiZact™ tonsillectomy device compared to the commonly used cold steel dissection technique with bipolar cautery in adults. Design Retrospective case control study. Parameters analysed for significant association with technique were operating time, intraoperative blood loss, wound pain on postoperative days 1–4 and rate of post‐tonsillectomy bleeding (PTB). Setting Monocentric study at a department of otolaryngology and head and neck surgery at a tertiary centre in Germany. Participants A total of 183 patients who underwent a bilateral tonsillectomy with either the BiZact™ tonsillectomy device or the cold dissection technique with bipolar cautery for haemostasis. Main Outcome Measures Operating time, intraoperative blood loss, postoperative pain on the first to fourth postoperative day (numeric rating scale: 0–10) (PTB, primary bleeding ≤24 h, secondary bleeding >24 h postoperative; Stammberger scale). Results and Conclusion The BiZact™ tonsillectomy device leads to a significant shorter operating time with less intraoperative blood loss compared to cold steel dissection with bipolar haemostasis. No benefits with regards to PTB or postoperative pain could be observed. The use of the BiZact™ device provides major benefits in clinical routine and stands up to conventional tonsillectomy techniques.