Objective To evaluate the clinical efficacy and prognosis of children with obstructive sleep apnea hypopnea syndrome (OSAHS) after surgical treatment. Methods Clinical data of 106 children with OSAHS were retrospectively analyzed, including 16 cases (15.1%) aged <3 years, 64 cases (60.4%) aged 3-6 years, and 26 cases (24.5%) aged >6 years. Among them, 83 cases (78.3%) underwent adenoidectomy combined with tonsillectomy and 23 cases (21.7%) underwent adenoidectomy alone. They were followed up in outpatients after operation, and children with complications were treated with pediatrics. Results All patients were operated smoothly, and their sleep at night was significantly better than that before operation. Fever occurred in 3 cases 1 day after operation (1 case with repeated high fever), and their body temperature returned to normal after pediatric anti-infection and antipyretic treatment. All patients were followed up for 12-20 months, with an average of (16.0±1.4) months. At 12 months after operation, 88 cases (83.0%) were cured, 13 cases (12.3%) were improved, and 5 cases (4.7%) were ineffective. Within 6 months after operation, 1 recurrence was found in children aged <3 years; at 12 months after operation, 5 recurrence cases (31.2%, 5/16) were found in children aged <3 years, while no recurrence occurred in children aged 3-6 years or >6 years, showing significant difference (both P<0.05). Seven cases of children aged <3 years with recurrent respiratory tract infections within 12 months after operation were cured after combining the follow-up of pediatrics (anti-infection and immunoregulation treatment). Conclusion Surgical resection is still the main treatment for children with OSAHS, and appropriate operation should be selected according to different obstruction causes; children aged <3 years should be operated cautiously after the assessment of risk and prognosis; meanwhile, follow-up after operation and treatment of related complications should be jointly done with professional pediatricians to reduce long-term poor prognosis.