Objective To detect the distribution of serum specific immunoglobulin E (IgE) and level of total IgE in children with adenoid hypertrophy, and investigate the relationship between the degree of adenoid hypertrophy with the levels of serum specific IgE and total IgE.Methods A total of 186 children with adenoid hypertrophy undergoing adenoidectomy from Aug 16, 2018 to Oct 19, 2020 were included. The distribution of serum specific IgE and level of total IgE were detected, and the relationships between the degree of adenoid hypertrophy and the levels of serum specific IgE and total IgE were investigated.Results Among 186 cases of adenoid hypertrophy,88 cases had second degree and 98 cases had third degree. Seventy-six children showed positive specific IgE results with a positive rate of 40.86%. The top three inhalant allergens were dust mite (26, 34.21%), Artemisia argyi (20, 26.32%), and mould (13,17.11%). The top three food allergens were egg white (23, 30.26%), milk (10,13.16%), and soybean (8, 10.53%). Among the children with second degree of adenoid hypertrophy,28 cases(31.82%) with allergen positive,and among the children with third degree of adenoid hypertrophy,48 cases(48.98%) were allergen positive.Children with positive allergens had larger adenoid than those without (χ²=5.65,P=0.02). However, the degree of adenoid hypertrophy had no correlation with the levels of serum specific IgE and total IgE.Conclusions The major allergens for children with adenoid hypertrophy are dust mites, egg whites and Artemisia argyi. Children with positive allergens may have larger adenoid, but the degree of adenoid hypertrophy has no correlation with the serum level of IgE.