Objective To compare the surgical outcomes of temporal lobe epilepsy patients with different disease courses and to investigate the relationship between surgical outcome and disease course.Methods To compare the surgical outcomes of temporal lobe epilepsy patients with different disease courses and to investigate the relationship between surgical outcome and disease course.Results A retrospective analysis was performed on 183 patients with temporal lobe epilepsy who received surgical treatment in the Department of Neurosurgery, Affiliated 363 Hospital, Luzhou Medical College from January 2002 to January 2011. The surgical outcomes of patients with different disease courses were evaluated based on Engel's classification, and the relationship between disease course and surgical outcome was analyzed. Results After operation, the early surgical treatment group had a significantly higher seizure-free rate than the middle surgical treatment group and late surgical treatment group (78.9% vs 67.9% and 58.6%, P<0.05). The course of disease was negatively correlated with surgical outcome (r=-0.213, P=0.002); the longer the duration of disease, the worse the surgical outcome.Conclusions Early surgical intervention may be more beneficial for controlling temporal lobe epilepsy and improving patient's quality of life.