Chorney SR, et al. - Using Healthcare Cost and Utilization Project Kids' Inpatient Databases, researchers sought to examine outcomes after tonsillectomy among children with gastroesophageal reflux (GER) and analyze the duration of hospitalization and total charges after admission. In total, 21,232 children had a tonsillectomy with or without adenoidectomy, with 1,683 (7.9%) diagnosed with GER. It was noted that average age for individuals with reflux was 4.4 years and for those without was 5.6 years. Reflux patients were more likely to suffer respiratory problems, aspiration pneumonitis, and hypoxemia during their stay in the hospital. Within this population, noninvasive ventilation and reintubation occurred even more frequently. Children with reflux had a longer period of postoperative admission (3.8 vs 2.3 days) and higher overall hospital charges ($47,129 vs $27,584). Multivariable regression analysis showed that reflux remained a statistically significant indicator of aspiration pneumonitis, hypoxemia, invasive and non‐invasive ventilation, as well as admission duration. After tonsillectomy, children with GER were significantly more likely to encounter inpatient complications. Additionally, admission length was higher than that of children without reflux. Such findings indicate that children with GER experience poorer outcomes after tonsillectomy and emphasize the role of appropriate preoperative counseling and planning in this patient population.