Objective To evaluate the clinical efficacy of nasal endoscope-assisted low temperature plasma adenoidectomy. Methods 100 patients who underwent adenoidectomy from May 2012 to August 2016 were enrolled in the study. All the patients were randomly divided into the observation group (50 cases) and control group (50 cases). Patients in the observation group underwent nasal endoscope-assisted low-temperature plasma adenoidectomy, and patients in control group was treated with nasal endoscope-assisted electric adenoidectomy. The operation time, bleeding volume, recovery time of nasal ventilation, clinical efficacy, postoperative complications of the two groups were analyzed and compared. Results In the observation group, the operation time, bleeding volume, recovery time of nasal ventilation was (4.9 ± 1.6) min, (19.6 ± 5.6) ml and (2.9 ± 0.5) d, respectively, which was significantly less than that of the control group (11.9 ± 3.9) min, (61.6 ± 12.1) ml and (5.9 ± 1.6) d, respectively (P < 0.05). The clinical efficacy of the observation group and the control group was 92.0%, and 86.0%, there was no significant difference between the two groups (P > 0.05). In the observation group, the pain index was (1.8 ± 1.0), which was significantly lower than that of the control group (5.6 ± 2.1), the difference was statistically significant (P < 0.05), and there was no significant difference with respect to postoperative hemorrhage, fever and snoring (P > 0.05). In addition, there was no postoperative complication observed in the observation group, while, the complication rate of the control group was 10.0%, the difference between the two groups was statistically significant (P < 0.05). Conclusion Nasal endoscope-assisted low temperature plasma adenoidectomy is effective and safe in the treatment of adenoid hypertrophy with less pain and fewer complications, which can be used as a routine clinical treatment for adenoid hypertrophy in children.