<p class="abstract"><strong>Background:</strong> Tonsillar hypertrophy is a common clinical condition seen by an otorhinolaryngologist. Tonsils undergo hypertrophy due to recurrent infection or as a part of generalized lymphoid hypertrophy. The aim of this study is to clinically correlate the association between tonsillar hypertrophy and acute/chronic tonsillitis.</p><p class="abstract"><strong>Methods:</strong> 100 patients attending the Oto-Rhino-Laryngology Department at Vijayanagar Institute of Medical Sciences, Ballari, Karnataka with complaints of tonsillitis acute, chronic, acute on chronic, other ENT symptoms and asymptomatic patients were assessed for tonsillar enlargement using Brodsky Tonsillar Grading scale for tonsillar hypertrophy.  </p><p class="abstract"><strong>Results:</strong> Out of the 100 patients with tonsillar enlargement and the symptoms at presentation we observed a statistically significant (p=0.0001) irrespective of the severity of the infection to the tonsillar hypertrophy graded according to Brodsky tonsillar grade.</p><p class="abstract"><strong>Conclusions:</strong> It is a common prudence that most of the general public and majority of general physicians are of the opinion that tonsillar grades are related to clinical pathology. Our study reveals tonsillar hypertrophy and severity of clinical disease are not directly proportional hence our study indicates management of acute or chronic tonsillitis cannot be influenced by the grade of tonsillar enlargement. We can consider tonsillar enlargement as a guide for prognostic evaluation. We were unable to find any literature regarding our objective of study. Hence this study can be considered as a stepping stone for further in depth clinical studies.</p>