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Background: Waldeyer’s ring is composed from adenoid, tonsils, and other lymphoid tissue. They can be hypertrophied causing many symptoms to the patient. Adenoidal tissue usually hypertrophied physiologically at middle childhood and starts to shrink at late childhood. However, in patients over the age of 10 they may enlarge leading to a number of obstructive symptoms. Objectives: The aim of this study is to identify the risk factors and the presenting symptoms associated with adenoid enlargement in patients above the age of 12 year. Methods: 130 patients above the age of 12 year old who underwent adenoidectomy in the date from the first of January 2016 to the first of January 2021 were studied. Patients were evaluated at Otorhinolaryngology and Head & Neck Surgery department at Jordan University Hospital in Amman – Jordan. Patient’s data was collected via medical records or telephone interviews. Results: Of the 130 patients, 81 are males and 49 are females. The mean age of the sample was 19.68. The most common presenting symptom was snoring (81.5%). The second most common presenting symptom was nasal obstruction (75.4%) and mouth breathing (71.5%). The most common associated risk factor was septal deviation (44.6%) followed by passive smoking (40.8 %), allergic rhinitis (38.5%), and pollution (38.5%). Conclusion: There are multiple suspected risk factors of adenoid hypertrophy in patients aged above 12 year old. In our study, septal deviation was found to be the most widely associated factor followed by passive smoking, allergic rhinitis and pollution. Patients commonly presented with symptoms of snoring and nasal obstruction. [ABSTRACT FROM AUTHOR]