Objective To investigate the current procedure of presurgical evaluation and the efficacy and safety of surgical treatment for temporal lobe epilepsy. Methods The clinical data of 27 patients with refractory temporal lobe epilepsy who had operation from August in 2016 to November in 2018 in Shenzhen Second People's Hospital and Shenzhen University General Hospital were analyzed retrospectively. Multiple analysis was used in the presurgical evaluation, including seizure semiology, epileptic sequence of brain MRI (1 mm per slice), interictal Positron Emission Tomography( PET), Video EEG monitoring, epilepsy battery of clinical neuropsychological testing and stereotactic EEG monitoring( SEEG). A multi-disciplinary team was involved in the localization and evaluation of epilepsy foci and functional cortex, as well as making the operation plan. Results A total of 13 patients underwent primary resection after noninvasive assessment, and 14 patients underwent surgical resection after SEEG implantation. All patients were followed up for 6-34 months with an average follow-up time of( 19.93±9.00) months. Surgical efficacy was assessed according to ILAE class criteria. Totally, there were 22 cases of ILAE grade Ⅰ( 81.48%), 1 case of ILAE grade Ⅱ( 3.70%), 2 cases of ILAE gradeⅢ( 7.41%), and 2 cases of ILAE grade Ⅳ( 7.41%). The SEEG implantation group had higher ratio of ILAE grade Ⅰ comparing to no SEEG implantation group( 12/14 vs 10/13), the MRI positive group had higher ratio of ILAE gradeⅠ than the MRI negative group( 16/19 vs 6/8). However, there was no statistically significant difference between the two groups. For complications, one patient had intracranial hemorrhage after SEEG electrode implantation, one patient had delayed intracranial hematoma after anterior temporal lobe resection, two patients had transient oculomotor nerve injury, one patient had poor scalp incision, four patients had post-operation infection. There were no cases of cerebrospinal fluid leakage or visual field damage or any other complications. Conclusions With more detailed presurgical evaluation and SEEG implantation, the outcome of surgical treatment for refractory temporal lobe epilepsy is becoming more effective.