Background:Management of refractory status epilepticus in children is extremely challenging.Case characteristics:Two children with medically refractory status epilepticus, both of whom had lesional pathology on MRI and concordant data on EEG and PET scan.Intervention:Emergency hemispherotomy performed in both patients. A complete, sustained seizure freedom obtained postoperatively.Message:Emergency surgery is a treatment option in selected cases of drug refractory status epilepticus with lesional pathology and concordant data.