The first Gamma Knife radiosurgery for mesial temporal lobe epilepsy was performed in Marseille in March 1993. Since then, around 130 patients have undergone epilepsy surgery using Gamma Knife at Marseille Timone University Hospital. The majority of epilepsy surgeries in our epilepsy surgery program in Marseille are performed conventionally because we still consider epilepsy radiosurgery as underevaluated. All epilepsy patients in Marseille are treated in the context of a successive prospective controlled trial, and we are convinced that few of the radiosurgical indications have been scrutinized and evaluated with more rigorous methodology. Some other centers (Madrid, San Diego, San Francisco) have now treated patients with comparable results.