OBJECTIVE: To review the management of medically intractable epilepsy by performing temporal lobe resection. DESIGN: Retrospective study. SETTING: University teaching hospital, Hong Kong. PATIENTS: Eleven patients: seven women and four men (mean age, 28 years; range, 19-49 years) who underwent temporal lobe resection for intractable epilepsy from 1994 through 1998. MAIN OUTCOME MEASURES: Preoperative and operative aspects of treatment, postoperative complications, mortality, and seizure control before and after surgery. RESULTS: All but one patient had long-standing medically intractable temporal lobe epilepsy; the duration between the onset of seizure and surgery ranged from 12 to 27 years (mean, 17.2 years). A total of 12 resections were performed without any mortalities or major postoperative complications. After surgery, two patients became seizure-free without the need for antiepileptic medication; six patients were seizure-free but required medication; and two patients showed >90% of improvement in seizure control, whereas one patient showed between 50% and 90% of improvement. Nine (81%) of the 11 patients reported significant improvement in their social life and performance of daily activities. Two (18%) patients, including one with improved seizure control, reported no improvement in their performance of daily functions. CONCLUSIONS: Temporal lobe resection can produce significant improvements in patients who have medically intractable epilepsy. The risks of surgery are relatively small and justifiable.