How often do you have to have tonsillitis before they should be removed?

3-4 times annually: There is no precise answer to this question. But if the diagnosis of true suppurative (pus) tonsillitis had been diagnosed by a specialist, and your quality of life is significantly altered and if you have been on multiple antibiotics, then tonsillectomy by an ENT is indicated. Very rarely, recurrent strep tonsillitis may be lead to cardiac and renal disease. My number is 3-4 times a year.