INTRODUCTION Adenoid hypertrophy is a global health problem which causes major illness and disability worldwide. It is a symptomatic disorder of the upper airway induced by viral or bacterial infection on the collection of lymphoid tissues in nasopharynx. Adenoid hypertrophy is characterized by snoring, mouth breathing and sleep apnea. OBJECTIVE This study aim at determining the prevalence and management outcome adenoid hypertrophy among children under 8 years of age attended ENT department in KCMC METHODOLOGY This study was hospital based retrospective cross section study in which data was collected from ENT and medical record department of corresponding files for children under eight years old who presented with adenoid hypertrophy at ENT from January 2015 to December 2015.the collected data was processed and analyzed using statistical package for the social science (SPSS) version 16. A 95% confidence interval and P-value of 0.05 was considered significant RESULTS Of 230 children less than eight years admitted at KCMC ENT department, 160(69.6%) had adenoid hypertrophy. Most children were admitted due to 113(86.9%) with snoring, mouth breathing 109(83.5%), difficulty breathing 104(80%), sleep apnea 100(76.9%) and fever 68.8% Of 130 children, 126 recovered with recovery rate of 96.9% and 4 died with a mortality rate of 3.1%. The children had a mean hospital stay of 2 days. The most common complication of adenoid hypertrophy was sleep disorder breathing 106 (81.5%) and other complications were adenoid face 4(3.1%) and cardio-pulmonary deficiency 9(7%). CONCLUSION The prevalence of Adenoid hypertrophy in our setting is high and the common symptoms are snoring, mouthing, difficulty in breathing, fever and sleep apnea. The common complication is sleep disordered breathing and other complications are adenoid face and pulmonary hypertension.