The laryngeal mask airway presents certain advantages in the management of the airway during general anaesthesia. However, from the surgeon's perspective, there have been reports of problems occurring when the laryngeal mask airway is used in tonsillectomy. This study of 90 patients undergoing tonsillectomy suggests that surgical access is inferior with a laryngeal mask airway and the weight of tonsillar tissue excised is less. In addition the laryngeal mask airway needs to be changed to an endotracheal tube during the procedure in 11.4% of patients.