The epileptogenic zone of the classical entity “temporal lobe epilepsy” appears in most cases to be confined to the mesial temporal lobe. Its selective resection yields on average a similar seizure control as a wider standard resection of the temporal lobe, while the advantage lies in preserving function. Neocortical aspects of cognition appear to be better preserved after selective amygdalohippocampectomy than after standard temporal lobe resection in the language-dominant hemisphere, but the route of access also plays an important role. Less commonly, temporal lobe epilepsy is not caused by Ammon’s horn sclerosis, but by another kind of lesion in the hippocampus, a structural or functional disturbance located in the pole or in the neocortical part of the temporal lobe. It is important to recognize these variations during the preoperative workup in order to adapt the method and extent of resection to the individual findings.