Tonsillitis, an inflammation of the palatine tonsils, represents a common condition affecting both children and adults, manifesting in acute and chronic forms. Acute tonsillitis typically presents with sudden onset of sore throat, fever, dysphagia, and lymphadenopathy, often caused by viral or bacterial pathogens. Chronic tonsillitis, in contrast, is characterized by persistent or recurrent symptoms, low-grade inflammation, halitosis, and lymphoid tissue hypertrophy, which may contribute to complications such as peritonsillar abscess or systemic infection. Differences in etiology, symptom severity, microbiological profile, and response to therapy between acute and chronic forms are clinically significant and influence management strategies. While acute tonsillitis often responds to short-term antibiotic therapy and supportive care, chronic tonsillitis may require prolonged antimicrobial treatment, immunomodulatory approaches, or surgical intervention such as tonsillectomy. Understanding the clinical and microbiological distinctions between acute and chronic tonsillitis is essential for accurate diagnosis, effective treatment planning, and prevention of complications.