Adenoid hypertrophy is a common presentation in the growing age group. It results in varied symptomatology resulting in nasal obstruction, mouth breathing, snoring, nasal discharge and nasal intonation of voice. Diagnostic nasal endoscopy and plain radiograph are the two most widely done investigative procedures. In our study we have compared the results of these two diagnostic modalities in defining the grade of adenoid hypertrophy and establish the differences in results so that a proper diagnosis is made and appropriate management is initiated.