Abstract We analyzed the seizure outcome of 357 patients who were followed for at least 2 years after resective surgeries; 282 underwent temporal lobe resection and 75 had extratemporal lobe resection. This study confirmed that resective surgery provides sustained, positive benefits with a high seizure-free rate of nearly 80% for most medically refractory patients. In patients with no MRI-detectable lesion who underwent extratemporal lobe resection, however, Engel's class I–II (seizure-free or rare seizures) was achieved in less than 50% of patients. High-resolution MRI should be performed at the early stage of disease in all patients with partial epilepsies. The findings would certainly urge clinicians to actively select surgical intervention.