Eight patients with a prominent occipitotemporal vein on MR imaging, and ipsilateral temporal lobe epilepsy are reported. The ages of the patients ranged from 2 months to 12 yr. There were five males and three females. Abnormal electroencephalographic (EEG) findings were evident in all the patients, and they had focal seizures. MR images revealed prominent (4 mm or more in width) occipitotemporal veins in the ipsilateral sides, and otherwise unremarkable findings. Three similar patients have previously been reported in the literature. We speculate that a prominent occipitotemporal vein may represent a consequence or a cause of a certain type of temporal lope epilepsy. Further clinicoradiologic studies are required to clarify the question raised by these observations. Copyright (C) 1996 Elsevier Science Ltd