Over a 10-year period, 64 surgical operations were carried out on 55 patients suffering from refractory extratemporal epilepsy. Patient class outcome 3 years after the final surgical procedure showed that 9 patients (16%) were completely seizure free and 21 patients (38%) had less than a 50% reduction in seizure outcome. Corpus callosal section as a surgical procedure had the highest percentage (57%) of patients with a class 4 outcome. Corpus callosotomy as a final operation resulted in reduction in frequency and severity of 'drop attacks' in all patients. Gliosis without atrophy was the most common histopathology. There were no deaths as a result of surgery, although 4 patients died postsurgery; 2 died in status epilepticus. Multiple lobectomy was the most successful surgical procedure, with a Prognostic Index of 2.0, followed by 2.5 for extratemporal tumour resection. Corpus callosotomy and cystectomy had a Prognostic Index of 3.3 and 3.1, respectively.