Methods: This prospective study included 71 children aged 3-10 years old attending Rizgary Teaching Hospital for adenotonsillectomy between August 2013 to January 2014. Questions about upper airway obstruction symptoms were directed to parents and patients. Tympanometry and plane radiological study of lateral soft tissue of the neck were done for each case. Tympanometric type A and C1 were considered normal while B and C2 as abnormal. The adenoid size was measured by using adenoidal/nasopharyngeal ratio. Results: Of 71 children (142 ears), 20 children (40 ears) had gross adenoid enlargement, of which tympanometry was found to be normal in 75% and abnormal in 25%. In 28 children (56 ears) with moderate adenoid enlargement, tympanometry was normal in 78.6% and abnormal in 21.4%. Twenty three children (46 ears) had minimal adenoid enlargement, in which tympanometry was normal in 91.3% and abnormal in 8.7%. Conclusion: The study showed that adenoid size in children had an effect on tympanometric readings. Although the incidence of abnormal tympanometry was higher with the increased adenoid size but it was statistically non-significant.