Background: Tonsillectomy is one of the most commonly performed surgical procedures worldwide, primarily indicated for recurrent tonsillitis, obstructive sleep apnea, and other upper airway obstructions.This study aimed to compare the Dissection & Snare technique and Electrocautery technique of tonsillectomy in terms of intraoperative efficiency, postoperative pain, bleeding, recovery time, and complications in a randomized clinical trial.Materials and Methods: A total of 110 patients scheduled for elective tonsillectomy at a tertiary care hospital were enrolled and randomly assigned to Group A (Dissection & Snare, n = 55) and Group B (Electrocautery, n = 55). Intraoperative parameters (surgical duration, blood loss, hemostatic interventions), postoperative pain (VAS at 6 and 24 hours), postoperative bleeding (primary and secondary), recovery (diet resumption, hospital stay), and complications (infection, delayed healing) were analyzed. Results: The Electrocautery group had a significantly shorter surgical duration (25.42 ± 3.89 min vs. 30.12 ± 4.98 min, p < 0.001) and less blood loss (30.41 ± 7.65 mL vs. 50.23 ± 9.87 mL, p < 0.001). However, postoperative pain was significantly higher in the Electrocautery group at 6 hours (VAS: 8.21 ± 1.05 vs. 7.52 ± 1.12, p = 0.004) and 24 hours (VAS: 6.47 ± 1.12 vs. 5.23 ± 1.08, p = 0.001). Postoperative bleeding was more frequent in the Electrocautery group (20.00% primary, 29.09% secondary) than in the Dissection & Snare group (10.91% primary, 20.00% secondary), with p = 0.035 for no bleeding. Recovery was significantly faster in the Dissection & Snare group, with earlier diet resumption (3.12 ± 1.02 vs. 4.52 ± 1.28 days, p < 0.001) and shorter hospital stay (2.34 ± 0.56 vs. 3.12 ± 0.72 days, p < 0.001). Complication rates were significantly higher in the Electrocautery group (infection: 18.18% vs. 10.91%, p = 0.035; delayed healing: 30.91% vs. 14.55%, p = 0.025).Conclusion: Electrocautery tonsillectomy provides shorter operative time and reduced blood loss, but at the cost of higher postoperative pain, delayed healing, and increased complications. Conversely, Dissection & Snare tonsillectomy offers a smoother recovery, lower complication rates, and less postoperative morbidity, making it a clinically preferable option despite a slightly longer surgical time. The choice of technique should be tailored based on patient factors and surgeon expertise.