A retrospective cohort study was conducted with the aim to characterise tonsillectomy patients and identify factors related to the development of complicated cases of tonsillitis and consecutive immediate tonsillectomies in the Latvian population. The data of 493 patients were analysed. Patients were hospitalised from 1 January 2019 to 30 November 2020, for elective or immediate tonsillectomy due to recurrent tonsillitis, with or without exacerbation and complications. The patients who underwent elective tonsillectomy were younger than those who underwent immediate tonsil-lectomy. Peritonsillar abscess was more common in smokers than in non-smokers (