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BACKGROUND: This study was to evaluate the application of ERAS in pediatric patients undergoing tonsillectomy and adenoidectomy. METHODS: Sixty patients were randomly divided into ERAS and control group. Patient outcomes, including hospital stay, operation time, bleeding volume, total cost, complications, m-YPAS, FLACC, and RSAS were observed. RESULTS: The length of hospital stay, total cost, and the incidence of postoperative nausea and vomiting in the ERAS group were significantly lower than those in the control group. The RSAS score, m-YPAS and FLACC score of the ERAS group were lower than those of the control group. CONCLUSIONS: Our study shows that the application of ERAS can reduce hospital charges and postoperative pain from tonsillectomy and adenoidectomy in children.