Objectives: Levetiracetam (LVT) is a new antiepileptic drug (AED) that recently has been available for use in children in Korea. The aim of this study was to ascertain the efficacy, tolerability and retention rate of LVT during long period in children with refractory epilepsies. Patients and methods: In this retrospective study, we reviewed the medical records of the children with intractable epilepsies, who began to take LVT between January, 2007 and July, 2007. All of them were less than 19 years of age and have been followed up for more than 2 years. We collected the data about demography, etiology, seizure and epilepsy classification, retention rate of LVT, causes of discontinuation and side effects. Results: This study included 107 patients (M:F=68:39). All of them had intractable epilepsies; they used mean 4 (1~6) AEDs before using LVT and mean 3.07 AEDs simultaneously with LVT. The mean dosage of LVT used in the patients was 42.9 (10~83) mg/kg/day. 46 patients (43%) had symptomatic etiologies and the others cryptogenic causes. 84 patients (78.5%) had partial seizure with or without secondary generalization, 26 patients had generalized seizure, one had infantile spasms. The retention rate was 68.2% (N=73) and most of them (N=63, 63.6%) were using other AEDs concurrently with LVT. The causes of discontinuation were ineffectiveness (23/34 patients, 67.6%), adverse events (N=2), both adverse events and ineffectiveness (N=6), aggravation of seizure (N=2). 15 patients (14.0%) obtained seizure free state with LVT; one of them discontinued all AEDs and maintains seizure free for more than 6 months. Including them, 24 patients (22.4%) had decreased seizure frequency more than 90%. The most concerning adverse events were violence (N=19, 17.8%), headache (N=5) and emotional instability (N=4) which were responsive to dose adjustment in some patients. 15 patients initially showed marked improvement with LVT but went back to previous state over 3~12 months period. Conclusions: LVT was well tolerated in children with intractable epilepsy with a retention rate of 68.2% at 2 year and good efficacy. The common side effects of LVT were mostly responsive to dose adjustment. We can use LVT safely as an adjunctive therapy for childhood intractable epilepsy.