The results of the first randomized controlled trial popularly known as Childhood adenoidectomy and tonsillectomy (CHAT) in otherwise healthy children of older age (five to nine years) are at best intriguing. These subjects diagnosed with mild to moderate Obstructive sleep apnea (OSA) by polysomnography (PSG) underwent the recommended first line treatment adenotonsillectomy (AT) or watchful waiting. AT provided benefit in terms of quality of life, improvement in symptoms and behavior. There is high quality evidence that AT is beneficial in terms of improvement in PSG parameters. On the contrary, high quality evidence indicates lack of benefit in objective measures of attention and neurocognitive performance compared with watchful waiting. Since its publication, CHAT database has been used for many follow up randomized trials with assessment of cardio-metabolic and demographic variables, respiratory parameters, complication rates, and weight gain.