Objective To analyze the spectrum of neoplasms associated with refractory epilepsy and to evaluate the optimum surgical treatment of these patients. Method The clinical, electrophysiological, operative,and histopathological data of 45 patients who underwent surgery for medically intractable epilepsy were retrospectively evaluated. Results The majority of tumors were located in the temporal lobe(n = 34) and frontal lobe (n = 8). The most frequent tumors were neuronal and mixed neuronal-glial tumors (76%), including gangliocytoma or ganglioglioma(n = 15), dysembryoplastic neuroepithelial tumour(n = 7). All the tumors were low histopathological grade (WHO Ⅰ or Ⅱ). In all patients, complete resection of tumor and epileptogenic area was intended. Complications were encountered in 5 patients. Of the 45 patients who had postoperative follow-up more than one year, 78% were seizure-free and no patient died. Conclusions The neoplasms associated with medically intractable epilepsy constitute a distinct clinicopathological group of tumors. Complete surgical removal of the tumors and the epileptogenic area can achieve excellent seizure control