Tonsillectomy is a painful procedure with discomfort continuing for days after the operation. We investigated whether topical application of a neurolytic agent (ethanol) to the tonsillar bed following dissection could provide long-term analgesia. Sixty-four patients undergoing tonsillectomy were randomized using matched pairs, to receive topical ethanol applied to the operative site, or saline for three min, in a double-blind study. Endpoints included self-reported pain using a pictorial pain scale, analgesia consumption adjusted for body mass, and weight loss. Follow-up continued until day 7 postoperatively. Both groups received the same analgesic protocol including infiltration of the operative site with ropivacaine. There were no significant differences in pain scores, analgesia requirements or weight loss between groups for any time period. The incidence of severe pain was significantly greater on the third post-operative day compared with day 1 and 2 (p = 0.0096). Topical application of ethanol does not reduce post-operative pain.