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IntroductionAdenotonsillar hyperplasia in childhood is a common phenomenon. It has been reported in the literature that increased upper-airway resistance resulting from hypertrophied tonsils and adenoids can cause intermittent airway obstruction, chronic alveolar hypoventilation, and even lead to severe cardiopulmonary complications such as right ventricular (RV) failure and cor-pulmonale, a near-lethal culmination of pulmonary artery hypertension (PAH). This study was undertaken to explore and examine the association of adenotonsillar hypertrophy and cardiopulmonary status in patients with complaints of upper airway obstruction below the age of 20 years and to analyze the effect of adenotonsillar enlargement on pulmonary function tests and cardiac aberration reflected in the electrocardiography (ECG) changes. MethodsThis study included patients visiting or admitted to the Otolaryngology/Ear, Nose, and Throat (ENT) and