Purpose: To analyze the main clinical and neuroimaging findings, postsurgical results in children with mesial temporal lobe epilepsy (MTLE) with and without presence of hippocampal sclerosis (HS).Material and methods: We analyzed the clinical histories of 30 patients with MTLE and with minimum 12 month of postsurgical follow up.Results: All patients were divided for 4 groups according to the age (from 7 to 15 y.o.) when MTLE diagnose were made. The mean age of patients with MTLE was 12, 5 y.o. Gender tendencies were higher in female. Only 2 patients presented family history of epilepsy (none of these relatives had MTLE). In 30% of patients we found the pathological background, in 2% - previous encephalitis as a possible trigger cause of MTLE and the other patients -presented mental retardation, as possible sequence of MTLE. In 32% of patients the history of febrile seizures (simple febrile seizures) had confirmed. Among these patients – 80% had positive biopsy result for HS and positive MRI findings compatible with HS. Clinically 62% of patients had aura and in 71% patients the seizure semiology was presented by ipsilateral automatisms with secondary generalization. In 14 patients MTLE findings were positive; in 33% of patients MRI was normal. In 33% of cases the biopsy of HS was confirmed. According the Engel scale 71 % (15) of patients were seizure free. Conclusions: The history of previous febrile seizures confirmed in 32% of children with MTLE. The surgical treatment was successful in most patients with early presurgical evaluation.