<p>Background: Adenoidal hypertrophy (AH) and childhood rhinitis are common paediatric conditions that significantly impact respiratory function and overall quality of life. The correlation between these conditions contributes to chronic nasal obstruction, recurrent infections, and sleep disturbances. A deeper understanding of their association is essential for optimizing diagnostic approaches and therapeutic interventions. Materials and methods: A cross-sectional study was conducted on 100 children (55 males, 45 females) aged 4–12 years presenting with persistent nasal symptoms. Participants underwent detailed clinical evaluations, nasal endoscopy, and radiological assessments to classify AH severity and rhinitis subtypes. Statistical analyses, including correlation and multiple linear regression, were utilized to examine associations between AH severity, rhinitis, and quality-of-life outcomes. Results: AH was identified in 68% of the cohort, with allergic rhinitis being the predominant form in 62% of cases. Rhinosinusitis was diagnosed in 45% of children with AH and rhinitis, demonstrating a strong clinical correlation. Higher adenoid-nasopharyngeal ratios were significantly associated with increased rhinitis severity (<i>p</i> &lt; 0.05). Regression analysis revealed that symptom severity, adenoid size, rhinitis type, and rhinosinusitis presence were significant predictors of reduced quality of life. Additionally, 70% of affected children reported sleep disturbances, and 50% experienced academic difficulties. Conclusion: This study establishes a significant association between AH and childhood rhinitis, emphasizing the necessity for early detection and a multidisciplinary management strategy. Integrated therapeutic approaches addressing both conditions can mitigate complications, improve nasal airflow, and enhance overall paediatric health. Future longitudinal studies are recommended to further elucidate disease progression and treatment outcomes.</p>