We aimed to compare the effects of microdebrider adenoidectomy, curettage adenoidectomy through oral cavity under 70°endoscope, and endoscopic transoral low-temperature ablation on adenoid hypertrophy. A total of 180 children suffering from adenoid hypertrophy hospitalized during November 2019 and November 2023 were allocated to group A (microdebrider adenoidectomy, n=65), group B (curettage adenoidectomy through oral cavity under 70° nasal endoscope, n=54), and group C (nasal endoscopic transoral low-temperature adenoid ablation, n=61). The operation data (operation time and bleeding amount), pain score, postoperative recovery, and complications were compared. The operation time of group A was significantly shorter than those of other two groups, while group C had a significantly smaller bleeding amount than those of other two groups (P<0.05). An incidence rate of secondary bleeding at 6.15% was detected in group A, without other complications. Group B had an adenoid residual rate of 35.19% and a recurrence rate of 14.81%, significantly exceeding those of other two groups (P<0.05). The soft palate injury rate was 24.59% in group C, which was raised significantly compared with those of other two groups (P<0.05). In comparison to other two groups, significant increases in postoperative pain score and pain duration were detected in Group C (P<0.05). There is no significant difference in the effective rate among the three methods. Nasal endoscopic transoral low-temperature adenoid ablation is recommended as the first choice because of small bleeding amount, few postoperative residuals, and low recurrence rate, but it poses high requirements on the operation of doctors.