PURPOSE: This study was designed to evaluate the safety and the reduction in seizure frequency of levetiracetam adjunctive therapy for pediatric epilepsy. METHODS: We retrospectively reviewed the medical records of 29 pediatric intractable epilepsy patients(male 19 and female 10). They all experienced more than two seizures per month, and were not controlled by initial combined two or more conventional antiepileptic drugs. They were followed up for over at least 3 months after prescribed levetiracetam from October 2005 to December 2006 at Sanggyepaik Hospital. RESULTS: 13 patients(44.8%) out of 29 showed reduction in seizure frequency of more than 50%, and 7 patients(24.1%) more than 75%. Of 14 patients who had generalized epilepsies including 9 patients with Lennox?Gastaut syndrome, 2 patients with severe myolonic epilepsy in infancy, 1 patient with late?onset infantile spasm, and 2 patients with undetermined generalized epilepsy, 4 patients(28.6%) showed seizure reduction of more than 50% and 1 patient(7.1%) of more than 75%. Of 15 patients who had partial seizures, 9 patients(60.0%) showed seizure reduction of more than 50% and 6 patients(40.0%) of more than 75%. There were significant differences between generalized seizure and partial seizure in those with more than 75% seizure reduction rate(Fisher's exact test, P=0.03). The mean maintenance dosage of drug was 34.8 mg/kg per day(5.7?71.4 mg/kg per day). The number of patients who showed adverse reactions was 9(31.0%) patients:increased seizure frequency in 4(13.8%) patients who discontinued levetiracetam, sedation in 3 patients and increased secretion and loss of appetite in one patient respectively in a descending order of of frequency. CONCLUSION: Levetiracetam is believed to be an effective, and safe anticonvulsant when used as an adjunctive therapy for various refractory childhood epilepsies.