It is one of the most complex and beautiful surgical subspecialty and requires huge amount of resources and involvement of many specialists. Epilepsy surgery in the modern era has been repeatedly shown to be safe and effective. It is reserved for people who keep having uncontrolled seizures despite multiple medications. Drug resistance has recently been defined by the International League Against Epilepsy (ILAE) as a “failure of adequate trials of 2 tolerated, appropriately chosen and used antiepileptic drug schedules (whether as monotherapy or in combination) to achieve sustained seizure freedom. It is not necessary to have frequent seizures to be considered for surgery if they significantly interfere with patient’s life. Unfortunately epilepsy surgery is still underused and many adults are referred for surgery consideration after many years of seizures. Chronic seizures increase risk of death, interrupt social interactions, interfere with employment and others. Early consideration for surgery is especially important in children as to avoid prolonged drug use and toxicity, improve child development and use recovery potential of young growing brain.