Objective Currently, there is no adult specific decision aid (DA) to support decision making around recurrent tonsillitis. This study intends to address this gap by piloting a prototype DA. Design Randomised clinical trial Setting Single centre trial at a tertiary otolaryngology department. Participants 43 patients were randomised to either the DA or Treatment as Usual (TAU) group. Main Outcome Measures Primary objective: To measure how patients rate the quality of their decision-making experience at the time of the decision and at follow up (SURE scale). Secondary objective: The level of decisional satisfaction at the time of the decision and at follow up; and to explore the numbers of people opting for surgery from each study condition. (SHARED tool and patient feedback) Results Quality: This study demonstrates no statistically significant difference in the degree by which patients rate the quality of their treatment decision between DA and TAU, both at baseline (P = 0.553) and follow-up (P = 0.062). Satisfaction: This study showed a statistically significant level of decisional satisfaction at the time the decision was made for Qu2 of the shared tool (U = 113, P = 0.026). No other significant difference was found between participants who received the DA and TAU. Conclusion The DA is an acceptable and useful tool which could be incorporated into the pathway for recurrent tonsillitis, helping to eliminate physician implicit bias. However, preliminary qualitative evidence from this pilot study does not suggest that inclusion of the DA improves the quality of decision making.