Epilepsy is one of the world's most common neurologic disorders and epilepsy surgery is a major treatment option for intractable epilepsy in pediatric patients. Understanding the sequential steps of epilepsy surgery is important for the selection of appropriate candidate for surgery. Surgical methods in epilepsy surgery should be decided according to the results of the presurgical evaluation and they can be categorized into resective surgery and disconnective surgery. The implantation of neuromodulation is also a potential surgical approach. Here, we reviewed the current state of presurgical assessment for intractable epilepsy in pediatric patients, novel surgical procedures, and associated outcome data.