Objective To analyze the risk factors of emergence delirium in children after tonsillectomy/adenoidectomy. Methods A total of 94 children who underwent tonsillectomy/adenoidectomy at Ningxia Medical University General Hospital from November 2022 to September 2023 were selected and divided into a delirium group (n=19) and a non‑delirium group (n=75) according to whether postoperative delirium occurred during the recovery period. Comparing the general information and preoperative laboratory parameters of the two groups of patients, variables with statistically significant differences between the groups [age, lymphocyte count, neutrophils/lymphocytes, monocytes/lymphocytes, modified Yale Preoperative Anxiety Scale (mYPAS) score, postoperative Pain Behavior Quantification Scale for Children (FLACC) score] were subjected to single‑factor logistic regression analysis, and variables with P<0.05 in the single‑factor logistic regression analysis were included in the multi‑factor logistic regression analysis. Analysis of independent risk factors for emergence delirium in children undergoing tonsillectomy/adenoidectomy. Results Nineteen out of 94 children (25.3%) developed emergence delirium. The age of the children in the delirium group was lower than that of the non‑delirium group, the proportion of mYPAS score and postoperative FLACC score>4 points was higher than that of the non‑delirium group, the preoperative lymphocyte count was higher than that of the non‑delirium group, and the preoperative neutrophil/lymphocyte count was higher than that of the non‑delirium group. The numbers of neutrophils/lymphocytes and monocytes/lymphocytes in the blood of patients in the delirium group are lower than those numbers in patients in the non⁃delirium group (all P<0.05). There were no statistically significant differences in other general information and preoperative laboratory parameters (all P>0.05). The results of single‑factor logistic regression analysis showed that young age [odds ratio (OR) 0.66 (95% confidence interval (CI) 0.445, 0.991), P<0.05] and high lymphocyte count [OR 1.57 (95%CI 1.026, 2.402), P<0.05], high mYPAS score [OR 1.03 (95%CI 1.004, 1.057), P<0.05], and postoperative FLACC score>4 points [OR 5.95 (95%CI 1.797, 19.687), P<0.05] are tonsil/ Risk factors for emergence delirium in children undergoing adenoidectomy. Multivariate logistic regression analysis showed that postoperative FLACC score>4 points [OR 5.32 (95%CI 1.470, 19.232), P<0.05] is an independent risk factor for emergence delirium in children undergoing tonsillectomy/adenoidectomy. Conclusions The incidence of emerging delirium in children who underwent tonsillectomy/adenoidectomy was 25.3%. FLACC score>4 is an independent risk factor for emergence delirium in children undergoing tonsillectomy/adenoidectomy.