This study compared the effects of bipolar electrocautery and cold dissection methods on tonsillectomy and adenotonsillectomy outcomes. This prospective randomized clinical trial study was performed on 500 patients who referred to a specialized ENT clinic with surgery indications. Inclusion criteria were obstruction of upper airway and chronic tonsillitis. Exclusion criteria included a history of tonsillitis within the last three weeks, hemorrhagic diathesis, hematological disorders, congenital malformed tonsils, craniofacial malformations, asymmetric tonsil appearance, neurological disorders, sensitivity to anesthetic drugs, peritonsillar abscess suspected or confirmed tonsillar malignancy, and diabetes. The candidate patients were randomized systematically and operated alternately by bipolar electrocautery and cold dissection methods. The study was double-blind, as neither the data collector nor the patient was aware of the groups. Different variables were assessed such as pain intensity, intraoperative and postoperative blood loss, pain intensity and referred pain in the middle ear, time to start eating after surgery, patient fever, nausea and vomiting, etc.