Tonsillectomy is the second most common operation undertaken in children in the United Kingdom, but the rate at which tonsillectomy is performed varies greatly across the Health Authorities. The reasons for the variation appear to be related to differences in local medical practice rather than differences in regional morbidity. This study was undertaken to compare the factors used to diagnose tonsillitis in children, the indications for tonsillectomy and the expected benefits of tonsillectomy in children by general practitioners, paediatricians and otolaryngologists. There was poor correlation between general practitioners, paediatricians and otolaryngologists in all study objectives. There appears to be no consistent clinical pathway by which children with recurrent tonsillitis are managed. The wide variation in tonsillectomy rates across the United Kingdom will probably continue until the decision-making process of doctors involved in the treatment of children with recurrent tonsillitis is better understood.