In a series of 33 patients undergoing tailored temporal lobe resection for mesial temporal sclerosis, the frequency of postoperative visual field deficit (VFD) was 52%. The size and configuration were similar after operation in the right and left hemispheres. We observed partial upper quadrantanopias in 16 of 28 patients who became seizure-free and in only one of five patients with residual seizures. VFDs may provide an independent measure of the functional extent of resection.