Objectives: The purpose of this study is to confirm whether there is a correlation between adenoid hypertrophy and the incidence of otitis media with effusion in children that are of school age or younger. Additionally, this study aims to clarify which age groups are at greater risk in having high grade adenoid hypertrophy associated with otitis media with effusion, and which are the most common presenting symptoms among those patients. Methods: Sixty- five patients aged 2-12 years old were included, and were placed into three groups according to age (2-5, 6-9, and 10-12). All of the patients were diagnosed with OME and were treated surgically (myringotomy with ventilation tube insertion and an adenoidectomy). Each patient had undergone pre-operative diagnostic procedures, including a detailed hetero-anamnesis and a clinical examination (otoscopy, rhinoscopy, and oropharyngoscopy). The diagnostic exams undertook include flexible nasofiberendoscopy of the nasopharynx and audiologic evaluations, including tympanometry and tonal audiometry. Results: There was an observed statistically significant incidence of patients with grades II and III grades of AH (P<0.001). Additionally, this study shows that there is neither a statistical significant difference between number of patients according to their gender, nor between the age of the patient and the grade of AH. Additionally, there is no significant difference between the distribution of grade II, III and IV of AH and the gender groups. The most common presenting symptoms include hearing impairment, snoring, and nasal obstruction. Conclusion: Children with a higher grade of adenoid hypertrophy have a larger risk towards the development of otitis media with effusion. Additionally, it is conclusive that a child who has failed conservative treatment for OME, and is indicated to surgical interventions, a grade of II or III AH is expected. All children who portray the listed presenting symptoms of AH should undergo a detailed workup and should be consulted by an otolaryngologist for a complete clinical examination and audiologic evaluation.