Abstract : Physical appearance of tonsils gives false assessment of its extent. Some of the tonsils lie on the surface of shallower tonsillar fossa, others buried in the tonsillar fossa give false estimation of its size. Subjective grading of tonsils may be affected by hypertrophic uvula, uvula-palatal arch variations and raised tongue position which in turn leads to inaccurate judgment. To determine the association between tonsil volume by Ultrasound and Brodsky tonsillar grading in adults. Fifty-four subjects with hypertrophic tonsils were selected from ENT Department of a Public tertiary care hospital with age ranges from 18 - 60 years. After taking written informed consent, subject evaluation Proforma was filled by the principal investigator which included a brief history, demographic data and physical examination. Tonsillar tissue was visualized and volume was calculated by using a standard ultra-sonographic formula (length X Width X Height X 0.523). Mean (SD) age was 25.72 (± 7.9) years. Males subjects were 29 (54 %) whereas 25 (46 %) were females. Maximum patients presented with tonsil grade II and III. Statistically significant linkage between Brodsky grading and ultrasonographic volume of tonsil was found, p-value < 0.001. In addition to clinical assessment of tonsils by physical examination more comprehensive imaging technique such as ultrasound should be considered for preoperative evaluation of tonsillar tissue for better decisions.