Methods of evaluating adenoidal size are contraversial. Previous studies have led to contradictory findings and have failed to put a plan for diagno¬sis of enlarged adenoids. The present study was conducted on 80 children diagnosed clinically to have enlarged adenoids . Detailed histories were taken from parents and complete general and oiorhinolaryngological ex-aminations were done followed by radiographic and fiberoptic examina¬tions of the nasopharynx . Cases shown to have enlarged adenoids by radi¬ography or endoscopy were submitted to examination under general anaesthesia to confirm the diagnosis before adenoidectomy which was done in the same sitting . Clinical evaluation was found to be reliable in assessing adenoidal obstruction of the nasopharyngeal airway. Radio¬graphs can be used when in doubt to confirm the clinical diagnosis. When the clinical picture is unclear flexible endoscopy can provide a definitive assessment of the status of the nasopharyngeal airway .