BACKGROUND: Choristoma is a rarely reported entity in the tonsil. Cartilage formation may be completely missed or, if large, may mimic and be misdiagnosed as a cartilaginous tumor. Complete excision of the tonsillar tissue along with the surrounding soft tissue, which may harbour perichondrium, is necessary. CASE: A 14-year-old female patient presented with re-current episodes of tonsillitis, for which she had undergone a tonsillectomy. Histopathological examination showed tonsillar tissue with reactive lymphoid cells with foci of mature hyaline cartilage, and thus she was diagnosed with cartilaginous choristoma of the palatine tonsil along with a focus of osseous metaplasia. CONCLUSION: Awareness of choristoma is necessary during examination of a tonsillectomy specimen to detect the lesion and differentiate it from other neoplastic and metaplastic conditions which may mimic it. Complete excision along with follow-up is necessary to detect recurrence. © Science Printers and Publishers, Inc.