Background & Aim: Tonsillectomy is the most common head and neck surgery in Iran. Considering that any operation involves three specimens and this can cause a considerable waste of time and cost, we intended to conduct a survey. The aim of designing and performing this research was to evaluate the value of histopathology done on all obtained specimens of adenotonsilectomy. Patients & Method: This retrospective study included 313 patients who had undergone adenotonsilectomy in Rasoul-e-Akram Hospital between 2000 and 2003. Fisher test was applied to analyze the information. Results: The age of the subjects ranged from 1 to 78 with an average age of 10.8. Only 3 cases(0.9%) who were above 50 years old yielded positive results. Considering p<0.01, there is a meaningful relationship between age and positive histological result. Also, a significant relationship was seen between malignancy and a change of voice in 60 cases(P=0.4), dysphagia in 26 cases(P=0.2, R=20%), unexplained weight loss in 1 case, asymmetric tonsils in 29 cases, neck mass in 34 cases(P=0.8), and infected tonsils in 15 cases(P=0.12). Therefore, the above-mentioned signs and symptoms can be considered as malignancy factors. Conclusion: Regarding the results of the study, there is no need to send tonsilectomy specimens to laboratory for histopathological evaluation, especially in children and patients without risk factors and clinical suspicions.