Medically refractory epilepsy is defined as failure to control recurrent seizures with two or more anti-seizure medication trials. Among patients with refractory focal epilepsy localized to the mesial temporal lobe, amygdalohippocampectomy is a well-established treatment that can result in seizure freedom in up to 75% of appropriately selected patients. Laser Interstitial Thermal Therapy (LITT) is a newer, minimally invasive alternative to resection, although the safety and efficacy of LITT is less well defined. This study aimed to compare outcomes among patients who underwent LITT vs. resections.