The objective was to retrospectively study the efficacy and safety of levetiracetam (keppra) as an add-on treatment of pharmacoresistant forms of epilepsy in children. We have analyzed medical histories of 192 patients with pharmacoresistant epilepsy admitted to a neurological department of the Research and Treatment Center of Children's Medical Care over the period of 2008-2011. The patient's age varied in the range from 6 months to 19 years (mean age 5.7 years). The results of the study revealed the high efficacy of levetiracetam as an add-on treatment of pharmacoresistant epilepsy in children. The efficacy of >50%, including patients in the remission, was found in 60.2%, the remission of more than 6 months was observed in 20.3% of patients. The efficacy of levetiracetam was higher in the treatment of the following variants of pharmacoresistant epilepsy: seizures caused by brain defects (the efficacy of >50% was seen in 66.7% of patients), atypical rolandic epilepsy (the efficacy of >50% was seen in 100% of patients). The efficacy of levetiracetam was not correlated with the priority of prescription of the drug that might be explained by the unique mechanism of the action of this anticonvulsant. Levetiracetam is well tolerated in the children age. Side-effects that were not life threatening were noted only in 6.2% of patients and the retention rate was 75.5%. The aggravation of seizures and EEG abnormalities, regardless of the epilepsy form, type of seizure, drug dose or the combination of anticonvulsants were seen in 5.7% of patients.