Background: For a long time, the hypertrophied tonsils impact on velopharyngeal closure has been a point of concern. Objectives: To identify the alterations in the velopharyngeal valve (VPV) closure patterns following adenotonsillectomy in Arabic-speaking children, to predict the incidence of complications as nasal regurgitation or open nasality. Patients and methods: This observational prospective research was performed on 100 patients, with hypertrophied adenoid and tonsils, who were collected from outpatient clinic of Benha University Hospitals. All cases underwent preoperative laboratory investigations, otorhinolaryngology examination and video-nasoendoscopy and speech assessment before and after adenotonsillectomy. Results: The VP closure pattern was insignificantly different between both groups. However, the Nasality was significantly different among the 3 studied periods(P<0.001). There was no relation between gender and VP closure pattern preoperatively and 1 month after surgery. Regarding the postoperative nasality (hypernasality), the most prevalent observed VP closure patterns were both coronal and circular ones. Conclusions: The coronal pattern of closure of the VPV is the most prevalent type, which remains even postoperatively, also the type of closure has no significant value in predicting outcoming hypernasality.