Purpose: This study was conducted to determine the prevalence and the pattern of distribution of tonsilloliths on panoramic radiographs.

  Materials and Method: This cross-sectional study was based on 2000 panoramic radiographs from 1030 female and 970 male aged 6-75 years old evaluated for the presence and pattern of tonsillolithiasis, between 2011 and 2013 in Shiraz, Iran. Chi–square test and odds ratio were used to evaluate the relationship between tonsillolithiasis and gender. p< 0.05 was considered as statistically significant.

Results: Out of the 2000 individuals, 101 cases (5.05%) had tonsilloliths on panoramic radiographs out of which 61 were male (60.4%) and 40 were female (39.6%), with age range of 18 to 65. Forty patients (39.6%) had both left and right sides involved, 25 of tonsilloliths (24.75%) were located on the right and 36 on the left side (35.65%). Men were more likely to develop tonsilloliths (p= 0.014).

Conclusion: Tonsilloliths are not very common finding and can be detected on nearly 5.05% of panoramic radiographs. Most of the cases are unilateral with a diameter less than 2mm.