Objective To analyze the change of allergen spectrum after following up for more than 3 years in children with adenoid hypertrophy and rhinitis. Methods Children who were diagnosed with adenoid hypertrophy and rhinitis in Department of Otorhinolaryngology Head and Neck Surgery，Capital Institute of Pediatrics affiliated Children's Hospital from July to October，2017 were enrolled and followed up to March 2021. Serum allergen specific IgE (sIgE)，size of adenoid，and modified Lund-Kennedy (MLK) nasal endoscopic score were collected. Results In total 36 children with adenoid hypertrophy and rhinitis were enrolled.9 (25%) were girls and 27 (75%) were boys，with the mean age of 7.8±2.5 years old.27 (75%) children had allergic rhinitis. Mold was the most common allergen，positive rate of dust mite sIgE decreased after 3 years (37% vs.24%，P=0.28)，and Artemisia sIgE increased. In children elder than 6 years old，Dermatophagoides pteronyssinus sIgE declined significantly (median 1.8 (IQR 1.2-2.6) vs.0.1 (0.0-0.7)，P<0.05). After drug treatment or surgery，adenoids were much smaller and MLK scores significant decreased than before (6.6±0.9 vs.4.3±1.6，P<0.05). Conclusion In children with adenoid hypertrophy and rhinitis，mold was the most common allergen，children with dust mite sensitization decreased after 3 years. Size of adenoid and MLK score were significantly declined after treatment.