In an effort to substantiate the efficacy of adenotonsillectomy in very young children, 108 procedures in one and two-year-old children were reviewed. After rigid preoperative criteria are met, a meticulous, conservative adenotonsillectomy is performed. A review of all hospital and office records shows the procedure can be safely and simply performed without significant complications. Seventy-nine parents were questioned regarding postoperative problems and results. Of the parents, 96% were satisfied and would have the procedure done again if they had the chance. Eighty-four referring physicians were polled and 87% thought the procedure solved the children's problem altogether or mostly. In conclusion, the results of this study show that, in carefully selected young children using expert anesthesia and atraumatic surgical technique, adenotonsillectomy under the age of three is a safe and gratifying procedure.