This study aimed to determine the significance of six clinical predictors associated with medically intractable childhood epilepsy. Materials and Methods: A retrospective cohort study was conducted. A total of 241 children with diagnosed epilepsy were recruited and divided into two groups: 61 patients with intractable epilepsy, and the other 180 patients who responded well to antiepileptic drugs. We investigated seizure semiology, etiology of epileptic encephalopathy, EEG abnormalities and defined the odds ratios (ORs) of predictor factors for intractable childhood epilepsy; age of seizure onset, asphyxia, neonatal intensive care unit (NICU) history, consanguineous marriage, abnormal neuro-imaging, neuropathologic exam, prematurity, parents' seizure history. Results: According to logistic regression analysis, the major risk factors for intractable childhood epilepsy are (1) neuropathologic examination p=0.