Pain is an important morbidity of tonsillectomy in children. Dexamethasone may lessen inflammatory response in the operative field, then decreasing the leakage of inflammatory mediators into the circulation and reducing the associated symptoms and signs including pain. To evaluate the role of a single intraoperative intravenous dose of dexamethasone (0.15 mg/kg) in controlling of early postoperative pain in tonsillectomized children. This work is a prospective double blinded, randomized case-control study of one hundred children aged 4 to 15 years who admitted for tonsillectomy from April 2017 to June 2019 at Alshifaa General Hospital, 50 of them were given dexamethasone 0.15 mg/kg intraoperatively as a case (dexamethasone) group, compared with an age-matched control group of 50 children, which consisted of children who received an equivalent volume of saline to evaluate the role of a single intraoperative intravenous dose of dexamethasone (0.15 mg/kg) in controlling of immediate postoperative pain in tonsillectomized children. the assessment of postoperative pain was done by using objective pain scale (OPS). Pain scores were significantly lowered in dexamethasone group (18%) in comparison to control group (40%) throughout the first 6 hours. Dexamethasone (0.15 mg/kg) provided significant reduction of immediate postoperative pain in tonsillectomized patients.