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Obstructive sleep apnea syndrome (OSAS) causes cardiovascular comorbidities and increased oxidative stress. Adenotonsillectomy is the first treatment option for OSAS secondary to adenotonsillar hypertrophy (ATH). This study evaluated the presence of cardiovascular changes, hypertension and oxidative stress before and after adenotonsillectomy in patients with OSAS secondary to ATH. Patients with ATH diagnosed with OSAS by polysomnography (PSG) were included. All participants received an Echocardiography (ECHO) and 24-h ambulatory blood pressure measurement (ABPM). Serum malonyldialdehyde (MDA) and total oxidant activity (TOS) levels of oxidant parameters; total antioxidant activity (TAS), catalase (CAT), superoxide dismutase (SOD) and glutathione (GSH) levels of antioxidant parameters were measured. All patients received an adenotonsillectomy. Postoperative evaluation was performed at the 6th month. In the postoperative period, PSG, ECHO, ABPM and the oxidant-antioxidant parameter levels in the serum was repeated. Twenty-eight patients (13 males, 15 females; mean age 8.2 ± 2.06 years) were included in the study. In the preoperative period, concentric remodeling was observed in 14,8% of the patients, although they had no cardiovascular system complaints. The apnea-hypopnea index (AHI) scores were classified as mild in 39.3% (n = 11), moderate in 21.4% (n = 6) and severe in 39.3% (n = 11) preoperatively. In the postoperative period, 22 patients were evaluated. It was observed that the severity of OSAS decreased, ventricular functions improved, oxidant parameters decreased and antioxidant parameters increased postoperatively. Adenotonsillectomy provides a positive change in cardiovascular system parameters and an antioxidant change in the oxidative balance in patients with OSAS. [ABSTRACT FROM AUTHOR]