Introduction: Tonsiliths, also known as tonsilloliths and tonsillar concretions or simply called liths, are stones that arise from calcium being deposited on desquamated cells and bacterial growth in the tonsillar or adenoidal crypts and occur in patients with or without a history of inflammatory disorders of either the tonsils or adenoids. Aim: This study was conducted to determine the prevalence and the pattern of distribution of tonsilloliths on panoramic views. Materials and Method: This study complied with the Helsinki Declaration as regards human subjects, in this a prevalence cross-sectional study, 401 panoramic views (266 female, 135 male, age 8 to 81 years old) of patients referring to a KKU dental clinic , between 2010 and 2017, were evaluated for the presence and pattern of tonsillolithiasis and oral and maxillofacial soft tissue calcifications. Results: A total of 401 pantomographs among them,(135) 66.3% were male and (266) 33.7% were female , were reviewed in the oral and maxillofacial radiology clinic of King Khalid University , Therefore, 401 subjects (135 males and 266 females) aged 8 to 81 years, were included for the data analysis, 84 subjects had single tonsiliths whereas 18 subjects had multiple tonsiliths. Discussion: Despite the fact that the cause and pathogenesis of tonsilloliths are not clearly known, the researchers believe that unresolved tonsillitis is the main factor .Conclusion: This study was done to, first, determine the prevalence of tonsiliths in patients attending the KKU Dental Clinic and, secondly, to investigate a correlation between ton siliths and other concretions. Tonsiliths are a major source of halitosis that is often overlooked by clinicians.