A 5-year-old girl with a medical history of asthma, allergic rhinitis, recurrent tonsillitis, and recurrent otitis media presented for evaluation of witnessed snoring, witnessed apneas, and OSA on diagnostic polysomnogram (PSG) despite two tonsillectomy and adenoidectomy (T&A) procedures. At 2 years of age she underwent a T&A procedure for witnessed snoring and witnessed apneas with tonsillar enlargement. When she was 4 years of age, persistent snoring and apneas with adenoid regrowth prompted a repeat T&A procedure. A diagnostic PSG 6 months after repeat adenoidectomy revealed an apnea-hypopnea index (AHI) of 3.5, a rapid eye movement AHI of 26, and a minimum oxygen saturation of 81% associated with sleep-disordered breathing. The diagnostic criteria for pediatric sleep apnea include an AHI ≥1.