OBJECTIVE: To determine if outpatient tailored perioperative management has the same complication rate as that previously published for sickle cell disease (SCD) children who undergo adenotonsillectorny. STUDY DESIGN AND SETTING: Retrospective chart review of SCD children who underwent tonsillectomy with outcome measures of perioperative management and postsurgical complications. RESULTS: Of 41 patients, 61% were monitored for < 24 hours with the average length of stay being 2 days (range, I to 10). Postoperative complications were noted in 9 (22%) patients, including 8 (20%) with hypoxia. 4 (10%) fever, 3 (8%) acute chest syndrome, and 1 (2.4%) airway fire, which are similar to the published literature. CONCLUSIONS: Current literature supports extensive perioperative management with hospital stays averaging 3 to 5 days. These data demonstrate that the majority of these patients can be managed with < 24-hour hospitalization stays with similar complication rates as previously described in the literature. SIGNIFICANCE: This Study establishes a new paradigm for perioperative management of SCD children Who undergo adenotonsillectomy. EBM rating: C-4 (c) 2006 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. All rights reserved.