Intractable or medically refractory epilepsy constitutes 10-20% of all epilepsies.Their diagnosis is important because they are surgically remediable.Epilepsy surgery has been established in many centres across India and the Neuropathologist plays a very important role in the epilepsy surgery team.The lesions associated with intractable epilepsy included mesial temporal sclerosis, focal cortical dysplasia (FCD), long term epilepsy associated tumors (gangliogliomas & dysembryoplastic neuroepithelial tumors), Rasmussens encephalitis, malformative vascular lesions, and glial sears.In our experience, the commonest was mesial temporal sclerosis followed by long term epilepsy associated tumors and FCD.It was also observed that CD34 is an important immunohistoehemical marker for diagnosis of FCDs and gangliogliomas.