Background: In otolaryngology practice, pediatric tonsillectomy is one of the most often done surgeries. We aimed to assess the short-term results of tonsillectomy alone versus tonsillectomy with local phenytoin with regard to postoperative pain, analgesia, bleeding and appetite. Methods: The study included in all 107 paediatric tonsillectomy patients; seven patients were excluded due to incomplete follow up only 100 patients completed follow up (60% female, 40% male, with age of (4–11 years) randomly chosen for tonsillectomy alone (group1 or TA; n = 50) and tonsillectomy with local phenytoin use (TPHT group, n = 50). Patient characteristics were recorded such as age, sex, and postoperative visual analogue scale (VAS), pain scores (2 hours postoperatively and first 10 days), appetite scores (first 7 days), also analgesia requirement (first 10 days) with documentation of bleeding complications. Results: From the third postoperative day, there was a noticeable decline in pain scores, which reached 0.0 ± 0.0.and on day 10 was 0.49± 0.79 in the TPHT and TA groups, respectively (p < 0.001 for each). comparing the TPHT group to the TA group, there were significant differences in pain and appetite scores from day 1 to day 10, as well as a decreased need for analgesia from day 1 to day 10. Additionally, there were few bleeding complications. Conclusion: The study of paediatric tonsillectomy patients proved effectiveness of local phenytoin use with tonsillectomy other than tonsillectomy without local phenytoin use.