Paratonsillitis is one of the most common urgent diseases of ENT organs. The objectives of the study included a retrospective analysis of patients’ complaints about acute exacerbation of chronic tonsillitis and its complications, as well as the study of the specific features of microbial spectrum of paratonsillitis pathogens and its changes at various stages of the disease. The authors analyzed the out-patient encounters logs for a 10-year period. In parallel, bacteriological studies of the contents of the cavities of paratonsillar abscesses in 76 outpatient patients treated for this pathology were conducted. It has been found that anginas and paratonsillitis occupy a significant position in the structure of urgent pathology of ENT organs, with a steady increase of the number of visits. At the same time, the statistics of planned surgical interventions for chronic tonsillitis and its complications indicate an insufficient use of surgical treatment methods The predominant paratonsillitis pathogens were: Streptococcus-β-haemolythicus, Streptococcus pneumoniae and Staphylococcus aureus, which had high levels of colonization. Cephalosporins and penicillins used as monotherapy, in most cases, did not completely suppress the growth of pathogenic microflora in the focus of inflammation. The authors revealed high level of non-clostridial anaerobic flora (in more than 20% of cases). Anaerobic flora was found in primary and repeated smears in the equally high percentage of cases, which indicates its resistance to the standard antibiotics used for the treatment of this pathology.