A review of the current debate with a focus on indication, technique and complications Pediatric tonsillectomy is amongst the most frequent pediatric surgeries and by far the most frequently performed intervention in pediatric otolaryngology. Considered an easy surgery, it is often taught very early in the specialist's training. In contrast to the technical ease, considerations regarding indication, timing, socio-medico-legal aspects as well as complications and their avoidance are currently still extensively debated. This controversial issue takes a closer look at aspects which could decrease the complication rates after pediatric tonsillectomy. Besides careful revision of indications and considerations of surgical techniques, the focus lies on newly discussed issues like post-tonsillectomy hemorrhage rates which are higher than previously thought and steroids given preventively in anesthesia. For pediatricians concerned about pediatric tonsillectomy and also for specialists (pediatric pneumologists, pediatric neurologists, sleep physicians, otorhinolaryngologists and pediatric surgeons) involved in diagnostics and surgery this controversial issue provides a valuable update on the current discussions.