BACKGROUND: Hypertrophy of the palatine and pharyngeal tonsils is extremely common in children, and is one of the most frequent causes of visits to otolaryngologists and such a problem can impair the child’s quality of life. The adenoidectomy and/or tonsillectomy surgical procedures are one of the most frequently performed otolaryngologist procedures in the pediatric population that are done as management of adenoid and tonsil disease, despite the large numbers of procedures being done there is limited information in Tanzania about these surgeries. Objectives: To determine the prevalence, indications and complications of adenoidectomy and/or tonsillectomy surgical procedure among patients below 15 years of age at ENT department at KCMC hospital from January 2015 to December 2015. Method: This was a hospital based descriptive cross sectional study of 562 participants ranging from 3months to 14 years (median age 4 years) who underwent adenoidectomy and/or tonsillectomy surgeries from January to December 2015. Data from OT registry was used to establish the prevalence and frequency of the surgeries and data from the participants’ medical records including social demographic, indication of surgery and complications were entered and analyzed using statistical package for the social science (SPSS) version 20, and descriptive analysis was done to give frequencies and percentages of indications and complication of the surgeries, and tables and figures were used to present the results obtained. Results: The prevalence of adenoidectomy and/or tonsillectomy surgeries was found to be 51.37% with male predominance at 60.1% with a 1.5:1 male to female ratio and the age group of 1-4 years being mostly affected. UAO was the major indication for surgery at 68.7% followed by infection and a combination of both at 8% and 23.3% respectively The overall frequency of complication was 3.9% with fever (2.5%), vomiting (1.2%), hemorrhage (1.1%) and fossa infection (0.9%) being mostly prevalent and of worth noting death had a 0.2% frequency. Conclusion: The prevalence of adenoidectomy and/or tonsillectomy surgeries at KCMC in 2015 was found to be 51.37% which is relatively high and thus shows that the diseases of the adenoids and tonsils and are not uncommon in the pediatric population and despite a low rate of postsurgical complication of 3.9% it is worth noting that individually surgery carries major risks and outcomes as shown from the patient who died post-surgery.