Clements AC, Walsh JM, Dai X, et al. - In this retrospective review, researchers sought to determine if there is a degree of obstructive sleep apnea syndrome (OSAS) severity based on obstructive apnea‐hypopnea index [OAHI] or hypoxia or hypercarbia that indicates a need for preoperative cardiopulmonary testing before pediatric adenotonsillectomy. The sample consisted of 358 patients ≤ 21 years with severe OSAS who underwent adenotonsillectomy at a tertiary hospital from June 1, 2016, to June 1, 2018. No significant associations were found between OSAS severity and test abnormalities. Despite the fact that pediatric patients with very severe OSAS (OAHI ≥ 60) had more pre‐adenotonsillectomy cardiopulmonary tests, OSAS severity did not anticipate abnormal findings. Cardiopulmonary testing could be indicated by known cardiopulmonary comorbidities rather than polysomnographic parameters, which may simplify and reduce the cost of pre-adenotonsillectomy assessment.