Abstract : Background: Sleep-disordered breathing is relatively a common problem in children. Adenotonsillectomy is not sufficient for pediatric obstructive sleep apnea syndrome. Objectives: to identify the role of inferior turbinate surgery in improving quality of life (Qol) and sleep disturbance patterns in children with obstructive sleep apnea. Methods: A cohort study was carried during the period from March 2021 to August 2021, at a tertiary general hospital in Al- Ahsa city. Sixty children aged 3 to 15 years having obstructive sleep apnea were enrolled into two groups; each group consisted of 30 children. First group underwent adenotonsillectomy concurrent with inferior turbinoplasty, while the second group underwent Adenotonsillectomy alone. Subjective outcomes were evaluated using the Obstructive Sleep Apnea -18 quality of life questionnaire (OSA-18). Results: It can be observed that the overall quality of life of patients was significantly better after the surgery (p<0.001), which also mirrored in all QoL domains such as sleep disturbance (p<0.001), physical symptoms (p<0.001), emotional symptoms (p<0.001), daytime function (p<0.001), and caregiver concerns (p<0.001). Also, the PSQ showed a significantly lower post-test score (p<0.001). Conclusions: Reduction in volume of the inferior turbinate plays an important role in treating pediatric sleep disorders and improve quality of life rather than adenotonsillectomy alone