Introduction: Otitis media with effusion (OME) is an inflammatory disorder of the middle ear that is characterised by the presence of endotympanic fluid without any sign or symptom of acute ear infection which may lead to hearing loss (HL) or long-term sequelae and have a negative impact on speech development and behavior. It is the prime cause of impaired hearing and social trouble in children which has long term impact on speech and language development. Enlarged Adenoid is a very common causative factor in the development of OME. Objective: To observe the hearing improvement after adenoidectomy alone in children with otitis media with effusion. Methods: This is a prospective descriptive study had been carried out in Dept. of ENT, Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh from January to December-2020. A total 45 patients aged 3 to 12 years old who had adenoid hypertrophy and OME, confirmed with pre-operative X-ray nasopharynx lateral view, PTA and tympanometry were included in this study. All patients underwent adenoidectomy under General anaesthesia. Follow up was done with PTA and tympanometry at 3rd months after operation. Result: Among 90 ears of 45 patients, pre-operative tympanometry showed type B curve in 53.33% of ears. Post-operative audiometric assessment showed mean hearing gain at 3rd month being 5.32 dB. At 3rd month follow up, 22 ears had type A curve, only 8 ears had type B curve and 60 ears had type C curve. Conclusion: So, adenoidectomy is an effective operation in correcting middle ear effusion and resulting hearing improvement as well as speech and language development in children with enlarged adenoid and OME.