Paediatric obstructive sleep apnoea (OSA) is not always resolved or improved with adenotonsillectomy. Persistent or complex cases of paediatric OSA may be due to sites of obstruction in the airway other than the tonsils and adenoids. Investigation of paediatric obstructive sleep apnoea (OSA) by drug-induced sleep nasendoscopy (DISE) may be of help in determining the level of obstruction and planning targeted therapy, but evidence is weak. The authors performed a retrospective review of the medical records of children (n=25) who underwent polysomnography and DISE (05/2012-12/2013). After DISE, the initial management plan changed in five patients (20%). The authors suggest this is a promising technique to help guide OSA treatment, but suggest further studies are required to predict persistent OSA based on this tool.