Over a period of ten months extending from November 1996 to July 1997 a total of two-hundred patients with symptoms of recurrent tonsillitis were studied. Age range from (2-62) years median (13). They included 93 male (46.5%) and 107 female (53.5%). The children were 109 (54.5%), the rest were adults (45.5%). A control group of twenty-five patients was studied. Both patients and the control group were the attendants of the University Teaching Hospital of Saddam College of Medicine, and from the regional hospitals of Baghdad area. Four methods of samples collection were used: 1- Surface culture. 2- Core culture. 3- Fine needle aspiration culture, (FNA). 4- Minced tonsillar culture. From the two hundred patients (four hundred tonsils) were examined for aerobic m.o. . A total of 1854 isolates were obtained, the most predominant aerobic and facultative organisms were H. influenzae 293 isolates (15.8%), S. aureus 248 (13.4%), S. pyogen 206 (11.1%) and S. pneumonias 66 (3.5%). Twenty-five tonsils from the above patients were studied for anaerobic bacteria. A total 187 isolates were obtained, the predominant anaerobes were Bacteriods spp. 60 isolates (32%), Veillonella spp. 40 (21.3%) and Fusobacterium spp. 25 (13.3%). The most prevalent aerobic bacteria in both children and adults was H. influenzae, (34%) and (36%) respectively. A higher concentration of//. Influenzae and 5. aureus was found in the core of hypertrophied tonsils in children as compared to recurrent tonsillitis. These findings suggests the presence of increased bacterial load and support the etiologic role of H. infJuenzae and S. aureus in hypertrophic tonsils. The total number of aerobic isolates from the tonsillar surface was 341 (18.4%) as compared to 481 (25.9%) from the core which is Statistically significant, also, the pathogenic flora inside the core were different from those on the surface. Surface flora are considered a poor indication of the type of infection. The number of isolates by the FNA were 499 (26.9%) which was quite similar to those from the core.Therefor FNA could replace tonsillar core culture in the study of core bacteria. Our findings indicates the polymicrobial aerobic and anaerobic deep tonsillar flora of children with recurrent tonsillitis. FNA Cytology and Histopathology was done on Twenty-five Tonsils: Fine needle aspiration cytopathology could replace histopathologic evaluation of tonsils with recurrent tonsillitis and might be of use for the study of tonsillar pathological changes and their relation to the different types of pathogenic organisms. We were unable to find a significant relation between smoking, had habit and number of episodes per year and the type of microorganisms, however, cervical adenitis was seem to be more common in children than in adults and with high incidence of//, influenzae