The number of patients who suffer from symptomatic partial epilepsy is significant, and those who undergo neurosurgery often experience refractory seizures. Levetiracetam (LEV) is a new-generation anti epileptic drug (AED). Previous studies have shown that LEV has favorable efficacy and a good safety profile with few drug interactions, as it has a unique pharmacological mechanism and acts on synaptic vesicle protein. This study aimed at estimate the efficacy and safety of 1,000 to 2,000 mg/day of LEV as an add-on therapy for refractory symptomatic seizures treated in the department of neurosurgery of our hospital. Twelve patients with >1 seizure attack per year who were administrated one to three AED(s) and had never used LEV were enrolled in this study. The follow-up period was at least 6 months. Seizure-free ratio, health-related quality of life (QOL), and tolerability were assessed. Fifty-eight percent (7/12) of patients were seizure-free, and their "overall QOL", "energy/fatigue" and "health status" distress-item scores in the QOLIE-31-P had improved. All patients were able to continue oral treatment with LEV without major side effects. Thus, the efficacy and safety of oral add-on LEV therapy were high for these patients. (Received January 19, 2016; Accepted September 2, 2016; Published December 1, 2016).