Summary:Epilepsy is the most common neurologic disorder in childhood and the majority of patients with convulsive disorders will have had the onset of their seizures during childhood. Since many children will outgrow their seizures or will be adequately treated with medication, there has been a reluctance to sending children for surgical evaluation and intervention with the hope that the natural history and seizures will be self-limited. Intractable seizures during childhood have been shown to lead to intellectual and psychosocial decline and affect the child's normal development. Surgery is an alternative treatment when medical treatment fails. The goal of early surgical intervention is not only to stop the intractable seizures, but to prevent further brain injury and/or interference from either the underlying abnormality causing the seizures, the seizures themselves, or the often toxic levels of antiepileptic drugs (AEDs) required for even some modicum of seizure control. This review will focus on the evaluative methods and surgical options available for the treatment of intractable epilepsy as it relates to children.