Background: Adenoid hypertrophy is known to be the most common cause of nasal obstruction in children; thus, adenoidectomy is one of the most commonly performed surgical procedures in children. Clinical assessment of adenoidal size is difficult, and objective measurement is desirable. Material/Methods: The study included 39 children (17 girls and 22 boys, 5-9 years of age, mean age: 6.7 years) with signs of perennial allergic rhinitis and suspicion of adenoidal hypertrophy. To establish the best radiological method to measure the adenoidal size, three different procedures (Johanneson, Fuijoka, and Cohen/Konak) were used. The methods were evaluated against the degree to which the adenoids obstructed the nasopharyngeal space on flexible endoscopy of the postnasal space. Clinical symptomatology was also evaluated against the degree of obstruction. To estimate the correspondence between the results, we used Spearman' correlation test. Results: The radiological method that best correlated with the endoscopic findings was that of Cohen and Konak, but neither radiology nor endoscopic scores correlated well with clinical symptoms. Conclusion: The side-pharynx x-ray may still be regarded as accurate and constitute an objective method for adenoid assessment in allergic children