We assessed the clinical features of 66 patients with pustulosis palmaris et plantaris who visited our hospital from January through May of 2010. Twenty-one patients were men and 45 were women. For the evaluation of tonsillectomy, improvement of skin lesions was classified into 4 grades; remarkably improved, improved, slightly improved and unchanged. The rate of improvement (remarkably improved and improved) by standard treatments other than tonsillectomy were 41.2% (21/51). The rate of improvement after tonsillectomy was 53.3% (8/15), but the rate of improvement of arthropathy was 16.7% (1/6). Tonsillectomy is considered as a helpful treatment for moderate to severe cases with pustulosis palmaris et plantaris.