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Background:Tonsillitis refers to viral or bacterial infection of the palatine tonsils. It presents in acute or chronic state. Tonsillitis usually associated with adenoid hypertrophy especially in children. Tonsillectomy is considered to be one of the most common surgical procedures held in otolaryngological theaters. Usually both tonsils are removed and adenoidectomy may be performed at the same time. Objective:This study is done because of limitation of data exist with respect to the recent prevalence of indications for tonsillectomy . We sought to determine the most common indications for tonsillectomy with or without adenoidectomy in Baquba Teaching hospital in Diyala governorate in different age groups and genders. Patients and Methods:The study involved 100 patients selected randomly from October 2016 to March 2017 viewed at the E.N.T. (Otolaryngology) ward in Baquba Teaching Hospital. The age group ranged from 3-28 years . Before surgery a detailed history and examination were taken from the patients themselves or their parents . Those patients all have a previous history of tonsillitis that was influencing their life style or school performance. Results: A total of 46% of our patients had infective causes or recurrent tonsillitis as an indication for tonsillectomy, while 27% had obstructive causes especially at night (obstructive sleep apnea) as an indication for surgery. In this study we found 6% of our patients, the surgery is indicated due to recurrent otitis media. Furthermore, 2% were due to peri-tonsillar abscess as indications for surgery. Conclusion: In this study, we present that patients who undergoing tonsillectomy with or without adenoidectomy, recurrent infective tonsillitis is more than obstructive tonsillitis (OSA) as indications for surgery. [ABSTRACT FROM AUTHOR]