Introduction. Branchial cleft anomalies (BCA) can occur as sinuses, fistulas or cysts. They arise from the first, second, third or fourth pharyngeal cleft due to non-fusion or subinvolution. Mostly, located in Robbin’s neck-level II, BCA clinically present as a painless compressible swelling, cutaneous draining sinus, or fistula. Surgical treatment is the gold standard to prevent recurrence, though the necessity of ipsilateral tonsillectomy is discussed. Study Design. We conducted a retrospective comparative cohort study. Setting. Monocentric. Methods. In retrospect, data was collected from patients, that were admitted with the diagnosis BCA between 2006 and 2020 in an academic tertiary care center. Main outcome measures. 160 patients met inclusion criteria, the data was further evaluated, the focus was set on the occurrence of recurrence with or without tonsillectomy. Results. Recurrence of BCA was observed in 2 out of 160 surgically treated patients (1,25%), one of them with simultaneous tonsillectomy, the other without. Conclusion. A statistically significant difference in the recurrence-rate between these two groups (with/without tonsillectomy) could not be shown. The performance of an ipsilateral simultaneous tonsillectomy in the surgical workup of BCA cannot be recommended at the basis of our data.