[Introduction ] Focal cortical dysplasia (FCD) is one of the most common etiology of drug resistant focal epilepsy. Although delineation of the lesion with brain MRI is very critical for better outcomes of epilepsy surgery, only half of FCD lesions can be found by routine visual inspection of the MRI. Here we describe a case of focal cortical dysplasia identified by cortical feature analysis and successfully treated by epilepsy surgery. [Case] A 19-year-old boy was admitted to our hospital because of pre-surgical evaluation for epilepsy surgery. He has been treated as drug resistant non-lesional focal epilepsy for 5 years ago. During monitoring, he presented several seizures with staring and lip smacking followed by left side eyeball deviation and forced head turning, sometimes evolving to secondary generalized tonic clonic seizures with left arm extension and right arm flexion. Ictal EEG showed runs of polyspike discharges from right frontal areas evolving to bilateral frontal fast activities and the inter-ictal epileptiform discharges were observed most frequently from right frontal areas. Brain PET (F-18 FDG) scans showed decreased metabolism of the right frontotemporoparietal cortex and brain ictal SPECT revealed diffusely increased perfusion of bilateral lateral temporal cortex. Using freesurfer analysis and comparison with 200 normal healthy controls, cortical feature analysis detected significantly increased cortical thickness in right inferior temporal gyrus of the patient and subsequent intracranial ECOG monitoring revealed the right inferior and posterior temporal onset ictal discharges. Right antero-mesial temporal lobectomy with posterior basal extension was performed and focal cortical dysplasia type 1C with abnormal radial and tangential cortical lamination was pathologically confirmed. After surgery, he has been seizure free more than one year. [Conclusion] Cortical feature analysis can improve the detection of structural lesion in patients with FCD and concomitant epilepsy. Further studies with large number of patients are needed.