Objective: To compare the clinical effects of CO₂ laser tonsillectomy and monopolar electrotome tonsillectomy. Methods: A total of 104 adult patients who needed tonsillectomy were randomly divided into a laser group and an electrotome group. The operations of the two groups were performed by the same surgeon, the patients of the laser group were operated on with CO₂ laser, and the patients in the electrotome group were operated on with monopolar electrotome. The operation time, intraoperative blood loss, postoperative pain score, evaluation of raw surface, time for the pseudomembrane to disappear, rehaemorrhagia and scar were observed. Results: The evaluation of raw surface of the laser group was better than that of the electrotome group (P<0.05), and the operation time of the electrotome group was shorter than that of the laser group (P<0.01). The laser group’s patients had significantly less pain than the electrotome group’s patients in the first four days after the operation (P<0.01), pain scores of both groups were nearly 0 on the 7th day after the operation, and the difference was not statistically significant (P>0.05). There was no statistically significant difference between the two groups in intraoperative blood loss and time for the pseudomembrane to disappear (P>0.05). No rehaemorrhagia occurred in both groups, and both groups had 1 case (1.92%) of scar. Conclusion: Without excessive pursuit of shorter operation time, CO2 laser tonsillectomy can get better evaluation of raw surface, less postoperative pain, little intraoperative blood loss and little postoperative complications, and should be promoted.