Cortico-amygdalo-hippocampectomy in our experience remains the surgical procedure of choice for the treatment of temporal lobe epilepsy. It allows removal of an ample amount of epileptogenic tissue, provides excellent exposure for the mesial structures and is not accompanied by significant intellectual deficit. It takes into account the fact that temporal seizures usually arise in the limbic structures but quickly recruit the whole anterior cortex in most instances. Selective amygdalo-hippocampectomy is an alternative approach when a clear mesiobasal limbic focus has been repeatedly demonstrated by intracranial recording.