Aim:Mesial temporal lobe epilepsy (MTLE) is the most common epilepsy syndrome caused by the unique epileptogenicity of hippocampal sclerosis (HS). Because surgical treatment is superior to medical treatment in MTLE associated with HS, patients with MTLE should be referred for early surgery. Thus, in this study, we aimed to analyze the epidemiologic, clinical, neuroradiological, and histopathological data of patients who have undergone anterior temporal lobectomy (ATL) for drug-resistant MTLE.Material and Methods:The study included patients who were diagnosed with MTLE refractory to medical treatment, underwent anterior temporal lobectomy at our institution between 2010 and 2020 and had postoperative clinical follow-up data. The epidemiologic, clinical, neuroradiological, and histopathological data of the patients were collected.Results:Fourteen patients were male, and thirty were female. The mean age at seizure onset was 15.3 years. Video electroencephalographic monitoring (VEM), magnetic resonance imaging (MRI), and positron emission tomography (PET) revealed lateralization in 37, 36, and 31 patients, respectively. The cranial MRI and PET were inconclusive in eight patients in whom the diagnosis was verified via invasive monitoring. Thirty-six (81.8%) patients were seizure-free postoperatively. The number and dosage of antiepileptic drugs used were reduced in 35 (79.5%) and 26 (78.8%) patients, respectively. Only six patients developed complications (cerebrospinal fluid fistula, n = 3; central nervous system infection, n = 2; and epidural hematoma, n = 1).Conclusion:Epilepsy is a significant cause of morbidity for patients, and surgery plays a vital role in treating mesial temporal sclerosis, an etiology of epilepsy. Patients can be diagnosed using various tests such as cranial MRI, electroencephalography, VEM, PET, single-photon emission computerized tomography, neuropsychological tests, and invasive monitoring at advanced epilepsy centers. Surgical treatment is highly effective and safe in these patients.