Background: Tonsillectomy is a frequent surgical intervention for recurrent tonsillitis in both adults and children, employing predominantly the cold steel method. Pain management post-surgery primarily involves NSAIDs and opioids, with varying degrees of effectiveness and side effects. Objective: The study aimed to evaluate the pain relief efficacy of combining ibuprofen with paracetamol compared to the use of ibuprofen alone in children post-tonsillectomy. Methods: Following ethical approval, 278 children with recurrent sore throat and quinsy were enrolled in an inpatient study at the Department of ENT, A unit of Hayatabad Medical Complex, Peshawar, from May 06 to August 30, 2023. This analytic cross-sectional study utilized a comparative prospective data collection approach and non-probability convenience sampling. Participants included 142 boys and 136 girls, aged 6 to 12 years. Results: Of the total 278 children, 142 (51.1%) were male and 136 (48.9%) female. Ibuprofen alone was prescribed to 136 children, while 134 received a combination of ibuprofen and paracetamol. Among those treated with the combination therapy, 65 (23.4%) reported no pain (VAS scores 1-3). In contrast, those receiving ibuprofen alone reported moderate pain (VAS scores 4-7) as follows: 2.2% (N=6), 11.2% (N=31), 19.4% (N=54), and 9.4% (N=26); and severe pain (VAS scores 8-10) was reported by 6.5% (N=18) and 0.4% (N=1). Conclusion: The combination of ibuprofen and paracetamol is significantly more effective in managing post-tonsillectomy pain in children compared to ibuprofen alone.