Acute tonsillitis is a common illness that affects patients of all ages but the risk of complication increases with the young. Tonsillitis commonly presents with a sore throat and difficulty swallowing and will often have swelling of the tonsils with exudate on physical examination. Although acute tonsillitis secondary to group A beta-hemolytic Streptococcus should be considered so that antibiotic therapy can be initiated in a timely fashion to prevent complications such as a retropharyngeal abscess or acute rheumatic fever, the most common etiology of tonsillitis is viral. The treatment of viral tonsillitis is supportive with analgesia and hydration.