The ideal outcome of epilepsy surgical treatment is to improve the quality of life of patients with refractory epilepsy by achieving complete clinical freedom from seizures and adverse drug effects, as well as no new injuries due to surgery. The presence or absence of seizures is the focal point for assessing the overall prognosis of epilepsy surgery, that is, whether surgery that provides patients with the opportunity to be seizure-free does significantly improve the emotional and psychosocial status of these patients. It is a fact that patients with temporal lobe epilepsy with hippocampal sclerosis or epilepsy characterized by focal lesions are the ones likely to have the greatest chance of postoperative remission (80-85%), whereas for other types, especially some epileptic encephalopathies and specific types of epilepsy syndromes, surgical intervention only improves the threshold and severity of epileptic seizures and remains dependent on longer-term medication. High-risk factors for continued postoperative seizures are: (1) site of surgery: complete resection of brain lesions with definite pathological significance is the strongest determinant of whether postoperative seizures can be controlled. Isolated temporal lobe lesion resection has the best prognosis, and the highest frequency of continued seizures after multiple lobectomy and resection of non-injurious lesions outside the temporal lobe. (2) Pathological nature of the epileptogenic focus and its distribution: Surgery in childhood or early adolescence is particularly effective when the pathological basis of epilepsy is hippocampal sclerosis, embryonic dysplastic neuroepithelioma, or ganglioglioma. Multiple pathological changes, such as hippocampal sclerosis accompanied by neuronal migration defects or penetrating brain cysts, or abnormal cortical development, are more likely to continue later if only a portion of them is surgically removed. (3) Age at the time of surgery: It is an important reference for prognostic assessment, and it is rare to benefit from surgery beyond the age of 45 years before surgery. This suggests that the indication for surgical treatment should be considered early when the patient fails with 2 separate AEDs as monotherapy. (4) Adequate seizure control in the first year after surgery: It has been suggested that early seizures within 2 months strongly predict a poor prognosis. If the first 2 years after epilepsy surgery are completely seizure-free (excluding seizures within 1 week after surgery), it is unlikely that seizures will continue in the future. In contrast, if there is 1 complex or secondary generalized seizure in the first year, 50% of patients will continue to have seizures that are at least incidental. Other clinical parameters that predict remission or recurrence include type of epileptic seizure, severity of epilepsy, persistent status epilepticus, epilepsy syndrome, EEG changes based on epileptic disorders, and age at onset, and although these findings are inconsistent in each study, it is generally accepted that symptomatic epilepsy of unknown origin with mental retardation, diffuse EEG changes such as slowing, reflecting the severity of epilepsy prolonged time required for seizure control with antiepileptic drugs, and the need for multidrug combinations when multiple drugs are ineffective alone are significantly associated with prognosis. The use of more than one medication, continued seizures despite medication, secondary generalized tonic-clonic seizures and myoclonic seizures, abnormal EEG, and being older than 16 years of age are all risk factors for reoccurrence.