ObjectiveTo explore the strategy and outcome of surgery for the treatment of encephalomalacia with secondary intractable epilepsy. MethodsDuring the period of July 2009 and June 2015, 21 cases of encephalomalacia with secondary intractable epilepsy were performed operation. Among them there were 16 males and 5 females. Their ages ranged from 4 to 34 years, with their illness duration from 3 to 14 years. According to the results of MRI and video-EEG monitoring, all the patients were performed operation under the monitoring of ECoG. And the outcome was graded by Engle scales for analysis. ResultsECoG monitoring after the resection of encephalomalacia showed that there was still abnormal discharge. Enlarged cortical resection was performed in 10 cases, and cortical coagulation in 3、anterior temporal lobectomy + resection of the hippocampus and amygdala in 4、additional callosotomy in 4. The post-operative follow-up of 1~7 years showed that Grade Ⅰ was observed in 10 cases、Grade Ⅱ in 5 cases、Grade Ⅲ in 3 cases and Grade Ⅳ in 3 cases.The total surgical effectiveness was 85.7%. ConclusionTo the patients of encephalomalacia with secondary intractable epilepsy, the epileptic lesion should be resected besides the resection of encephalomalacia. And the surgical effectiveness is satisfactory.