Objective To explore the effects of different internal diameters of endotracheal tubes on the pulmonary ventilation function of children with snoring disease during surgery. Methods One hundred children with snoring disease scheduled for adenoidectomy and tonsillectomy under general anesthesia with tracheal intubation were selected and divided into three groups,according to a random number table: a small diameter group [internal diameter (ID)=(ages/4+3.5) mm, group S, n=33], an appropriate group [ID=(ages/4+4.0) mm, group A, n=28], and a large diameter group [ID=(ages/4+4.5) mm, group L, n=29]. After mechanical ventilation under general anesthesia, the following respiratory parameters in the three groups were monitored during surgery: peak airway pressure (Ppeak), plateau airway pressure (Pplat), pulmonary compliance (C), forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) ratio (FEV1%). Results Ppeak, and Pplat in group S were (16.8±2.8) cmH2O (1 cmH2O=0.098 kPa）and (13.6±3.1) cmH2O, respectively, which were significantly higher than those in groups A and L (P<0.05). Ppeak, and Pplat were not significantly changed between groups A and L. FEV1% in group S was (77±5) % which was significantly lower than that in groups A [(80±3)%] and L [(82±5)%] (P<0.05). FEV1% was not significantly changed between groups A and L. Compliance was not significantly different among these groups. Conclusions Small endotracheal tubes can increase Ppeak and Pplat, and reduce FEV1%, with negative effects on pulmonary ventilation function for children with snoring disease during surgery.