Background: Lingual tonsil hypertrophy (LTH) evaluation could be performed by flexible fiberoptic laryngoscopy, lateral soft tissue cervical roentgen, CT scan, and magnetic resonance imaging (MRI).Lateral soft tissue cervical roentgen examination was considered as substitutes for diagnostic testing of LTH, which, aside from being cheaper, the examination could also be conducted in all hospitals and easy to be performed on children. Objective: To compare the lingual tonsil enlargement with examination procedure using lateral soft tissue cervical roentgen as an LTH diagnosis measure compared to the flexible fiberoptic laryngoscopy examination as the gold standard examination. Methods: A cross-sectional design study on 30 respondents of laryngopharyngeal reflux (LPR) patients whose conducted routine ENT physical examination, followed by flexible fiberoptic laryngoscopy examination along with lateral soft tissue cervical roentgen. Results: The sensitivity level of 65.38% was acquired from the statistical tests, along with specificity level of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 30.37%. Conclusions: Based on sensitivity and specificity, lateral soft tissue cervical roentgen examination could already be used as a diagnostic measure and have an accurate capability to diagnose LTH.