Mesial temporal sclerosis is the most frequent cause of drug-resistant temporal lobe epilepsy but has a satisfactory response to surgery, and is considered infrequent in children. Objective: To evaluate the clinical, electrographic and radiological spectrum of the disease in children. Method., Retrospective study by review of charts of 44 children with a diagnosis of mesial temporal sclerosis on magnetic resonance imaging, attended at the "Hospital das Clinicas" of the University of Sao Paulo Faculty of Medicine. Results: Febrile seizure was identified in the history of 54% of the patients. Injuries at the left side predominated in patients with schooling difficulties (p=0.049), in those with the first seizures between six months and five years (p=0.021) and in those with complex febrile seizure (p=0.032). Thirteen patients were submitted to surgery and of these, eight remained without seizures. Conclusion: Febrile seizure maybe related in a more direct way to the presence of left-side mesial temporal sclerosis.