Temporal lobectomy is an effective treatment for medically intractable seizures. The change in seizure status with prolonged postoperative follow-up is unclear. The authors followed 37 patients who underwent first time temporal lobectomy during childhood for at least 15 years. This study is the longest follow-up of children who have had a temporal lobectomy for intractable seizures. It demonstrates that seizure recurrence can increase with longer duration of follow-up.