Objective:To compare levetiracetam (LEV) and topiramate (TPM) monotherapy for epilepsy in children the efficacy and safety. Methods:Included from January 2007 to June 2009 for children with epilepsy treated 45 patients randomized to levetiracetam treatment group (A group) 20 cases of topiramate treatment group (B group) 25 cases. Therapeutic dose:A group of the initial dose of 25 mg/d,a weekly increase of 25 mg,target volume of 6 ~ 8 mg/(d.kg),in 6 ~ 7 weeks to achieve the target dose. Group B starting dose of 0. 5 ~ 1. 0 mg/(d.kg),according to the disease each week to increase 0. 5 ~ 1. 0 mg/(d.kg),the final maintenance dose of 4 ~ 6 mg/(d.kg). Follow -up of 3 ~ 12 months. Results:A group of levetiracetam monotherapy for a total effective rate was 85% ,B group of topiramate monotherapy in total effective rate was 88%. Conclusions:Levetiracetam and topiramate monotherapy for the treatment of epilepsy in children is safe and effective.