<p>Thalamic deep brain stimulation (DBS) is an established neuromodulatory treatment option for drug-resistant epilepsy (DRE), but presurgical markers associated with the postoperative response remain incompletely understood. We explored whether presurgical structural covariance network organization, particularly within the intrinsic thalamic structural covariance network, differs among good responders, poor responders, and controls. We included 27 participants with DRE who underwent thalamic DBS and 26 controls. Participants with DRE were classified as good responders (seizure reduction ≥ 50%) or poor responders (&lt; 50%). All participants underwent conventional MRI and 3D T1-MRI. For participants in the DBS group, MRI was acquired before DBS implantation, and postoperative CT was performed for electrode localization. Cortical and thalamic volumes, including 50 thalamic nuclei, were analyzed. Structural covariance network measures and volumetric data were compared across groups with adjustment for age, sex, and total intracranial volume. In the intrinsic thalamic structural covariance network analysis, good responders showed a lower average degree and rich-club coefficient and higher modularity than controls (<i>p</i> &lt; 0.05). Thalamocortical structural covariance network measures did not differ across groups. Thalamic volumes were reduced in both DBS groups relative to controls, with no differences between responder groups. Presurgical intrinsic thalamic structural covariance network organization differed between good responders and controls, suggesting a potential association with the DBS response. However, these findings should be interpreted cautiously and require validation in large cohorts.</p>