PURPOSE: The aim of this study was to describe the clinical course and outcome of the patient with epilepsy after acute febrile encephalopathy. METHODS: Medical records of the twenty patients with acute febrile encephalopathy from Mar. 2003 to Dec. 2011, were reviewed. The outcome of epilepsy over 12 months after discharge from encephalopathy was investigated and compared with non-epilepsy group on several clinical and laboratory aspects. RESULTS: All revealed negative on viral study. Eight of 20 patients evolved to epilepsy eventually and 3 out of them had a status epilepticus as initial manifestation. Five of them remained medically intractable. Two showed ongoing violent behavior during follow-up period and 1 had motor weakness of lower limbs for a year. All had non-specific brain MRI findings, except the one who showed suspected cerebritis of right basal ganglia on follow-up study. Five of 8 epilepsy patients showed epileptic discharges on the first electroencephalogram. Two of them showed sustained frontal spikes and one who had abnormal brain MRI findings showed left temporal spike on follow-up EEG. Longer period of altered mentality and more frequent epileptiform discharges on initial EEG appeared to be related with progression to epilepsy during follow-up period. CONCLUSION: Acute febrile encephalopathy in children may be related to poor seizure outcome and resultant psychomotor problems. Further studies including laboratory exams to define its pathophysiology would be needed.