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Horner’s syndrome, though very rare, is a recognized complication following tonsillectomy, as presented in this case report of a 4.5-year-old girl. She developed Horner’s syndrome after a tonsillectomy, which was performed using cold steel technique and bipolar diathermy for hemostasis. The patient exhibited symptoms such as ptosis, miosis, and anhidrosis on the left side, detected following a secondary post-tonsillectomy hemorrhage that required surgical intervention. No improvement in Horner’s syndrome was noted after 3 months. Our review of the literature revealed 15 documented cases of Horner’s syndrome as a complication of tonsillectomy, with an increase in recent years possibly due to the advancements in surgical techniques and heightened awareness of the condition. Interestingly, Horner’s syndrome occurred with a wide range of surgical methods, indicating that the etiology is likely multifactorial, involving factors such as surgical technique, anatomical variations, and the extent of cauterization. This report emphasizes the need for caution in the application of modern hemostatic techniques, advocating for a balanced approach that considers traditional methods like ligation and suturing, which may reduce the risk of such complications. Continuous reporting and further research are crucial to better understanding the mechanisms behind Horner’s syndrome following tonsillectomy and improving patient outcomes.