Aim: Adenoidectomy is a common surgery for ENT surgeons, often with little complications. There are only few case reports of lobular capillary hemangioma causing nasopharyngeal stenosis post adenoidectomy (1). Importantly, there are no reports within the authors knowledge of an acquired recurrent nasopharyngeal complete stenosis following an adenoidectomy. We aim to report such case in a paediatric patient and to highlight an uncommon but a significant complication of adenoidectomy. Method: A retrospective review of the patient records and relevant literature search was performed. Results: A 5-year-old male presented with difficulty breathing, persistent mouth breathing and nasal obstruction post adenoidectomy by a community otolaryngologist. He underwent a nasoendoscopic assessment which revealed bilateral complete stenosis of the nasopharynx. A CT sinus revealed a subtotal opacification of the posterior nasal cavity lumen with heterogenous densities (measuring up to 65 HU), with no bony component. A choanal stenosis repair was done with debridement of scar tissue, balloon dilation, kenacort and nasal splinting. Despite these measures, 2 repeat procedures were required, each 2 months apart, for restenosis of this fast-growing scar tissue. A histological sample showed a lobular capillary haemangioma. The patient maintained a patent nasopharyngeal airway and was referred for consideration of B-blocker therapy. Conclusion: An uncommon but debilitating complication of adenoidectomy is highlighted in this case. Whilst exact aetiology of lobular capillary haemangioma is unknown, trauma and reactive granulation response from the adenoidectomy was the likely cause of this case. Lobular capillary haemangiomas should be considered within the complications of adenoidectomy, and surgical techniques should be mindful of this possible outcome. Reference 1. Sims JR, Balakrishnan K. Obstructing pediatric nasopharyngeal lobular capillary hemangioma after adenoidectomy. Mayo Clinic. 2015