BACKGROUND: Adenotonsillectomy is one of the commonly performed paediatric otolaryngology surgical procedures Worldwide. As with all surgical intervention, it is associated with some potential complications in the hands of inexperienced otolaryngologists. Complications can be life threatening in some cases especially when the patient is inadequately prepared for the procedure and has co-morbidities such as sickle cell anaemia, ongoing infections and bleeding disorders. AIM: This study is to establish the complications of adenotonsillectomy as seen in a private hospital setting in Port Harcourt. It will also evaluate the outcome of management of complications and its attendant challenges. PATIENTS AND METHODS: It was a prospective study of all children who had adenotonsillectomy in Kinx Medical Consultant clinic which is an Ear, Nose and Throat specialist clinic in Port Harcourt, Nigeria within the period of January 2012 and June 2015. The adenotonsillectomies were done by an experienced otolaryngologist assisted by a senior registrar in the department of Ear Nose and Throat surgery department of University of Port Harcourt Teaching Hospital (UPTH). General anaesthesia was administered by a consultant anaesthtetist via endotracheal intubation with complete paralysis. Patient data were documented in a proforma and were analyzed for age, gender, indication for surgery, complications, management of complications and its outcome. The data were entered into SPSS version 20 computer software and analyzed descriptively. RESULTS: A total of 65 patients had adenotonsillectomy out of a total number of 128 surgeries carried out during the period of study, giving a prevalence of 50.78%. There were 30 males and 35 females giving Male to Female ratio of 1: 1.1. The age range was 1-10 years with mean of (2.5 ± 1.4) years. The age range 2-4 years has the highest number of complications 8(12.31%). The commonest complication encountered was postoperative pain 15 (27.08%) followed by post operative fever 10 (15.38%). All the complications were managed conservatively with the use of adequate analgesics, antibiotics and intravenous fluids. There was no life threatening complication seen in our series. The outcome of surgeries for all patients was satisfactory. CONCLUSION: All complications were successfully managed conservatively with good outcome. Parents and caregivers should not be scared of adenotonsillectomy procedure when their children or wards are booked by an experienced otolaryngologist in a good centre.