Aims and Objectives: To study the effect of single dose of intravenous dexamethasone (0.5mg/kg) on PONV in first 24 hours and on pain and oral intake upto third postoperative day, in children 4 to 12 years old undergoing Tonsillectomy with or without Adenoidectomy. Materials and Method: 66 patients, in the age group of 4 to 12 years, undergoing tonsillectomy with or without adenoidectomy were included in the study. 33 were injected with single dose intravenous dexamethasone just before surgery, while the remaining 33 were given same volume of saline. Results: Reduction in PONV and significant improvement in pain and oral intake. Discussion: Corticosteroids have been demonstrated to decrease local inflammation by blocking chemical mediators of inflammation thus reducing pain. Its mechanism of antiemesis is not fully understood, but central inhibition of prostaglandin synthesis and decrease in 5-HT turnover in the CNS or changes in the permeability of blood CSF barrier to serum proteins may be involved. Conclusion: Single dose dexamethasone given just before tonsillectomy results in reduction of postoperative pain and the need for rescue analgesics, early return to normal diet with better food intake and early hospital discharge.