We aimed to investigate the correlation of tonsillectomy with palatine tonsil size and to compare the differences of tonsil size and the need for surgery in children and adults. Also we can predict the outcome of tonsillectomy. We measured tonsil sizes in (height and width) in 150 children and 35 adults with hypertrophy of palatine tonsils and we measured the mass of tonsils and then the data analysis. In both groups of children and adults, tonsil sizes were significantly correlated with the rate of tonsillectomy. Tonsil size of grade 3 and 4 were with a high tonsillectomy rate in adults but tonsil size grade 2, 3 and 4 had a high tonsillectomy rate in children. Tonsillectomy correlated with tonsil size in both groups children and adults. The rate of tonsillectomy increased proportionally with tonsil sizes in both groups children and adults.