The last three decades have seen tremendous progress in the surgical management of patients with intractable epilepsy involving all facets of diagnosis, localization, operative technique, and research. Unfortunately, such progress has taken place and is in operation only in the developed countries of North America, Europe, and Japan. Epilepsy surgery programs in the developing countries of South America, Asia, and particularly Africa, if they exist at all, are the result of the individual efforts of physicians who were fortunate enough to receive their training abroad. These physicians face difficulties in financing their programs and in obtaining the necessary equipment, and they work without the assistance of trained personnel or technicians. The exchange of experience between physicians in developed and developing countries may be mutually beneficial. In the face of the high cost of health care in developed countries, it is unrealistic to expect patients with intractable epilepsy to continue to undergo elaborate investigative procedures indefinitely. On the other hand, physicians in developing countries need to keep updated on the latest technology and research and have to receive the necessary support from developed countries to slowly build up their programs. The global perspective of physicians dealing with epilepsy patients may be broadened by exposure to the experience from the "other side of the fence" and will ultimately lead to better patient education and more focused patient care.