Should the 2 tonsils be approximately the same size?does unilateral tonsil enlargement in adults warrant medical attention?

Tonsils: don't have to be exactly the same size. BUT a peritonsillar abscess could shift things over. Check this awesome article: http://emedicine.medscape.com/article/764188-overview ** if you have symptoms of peritonsilar abscess you should get emergency eval.

Yes: They are usually about the same size. if one appears much larger there can be an underlying abscess, for example. Cancer can appear in the tonsil as well; please see your doctor as soon as possible. If you have a fever and pain, get seen immediately.

Absolutely: Unilateral tonsillar enlargement should be evaluated by an Ear, Nose and Throat physician. Sometimes it can be normal but often it is due to a disorder in the larger tonsil that requires evaluation. Thanks for trusting HealthTap!