Epilepsy was known to the ancient Babylonians and was described by Hippocrates who considered it a disease of the brain.A seizure is a paroxysmal, time limited change in motor activity and/or behavior that results from abnormal electrical activity in the brain.Seizures are common in pediatric age group and occur in approximately 10% of children.Whereas all patients with epilepsy have seizures many more children have a single seizure during life and are not considered to have epilepsy.Over all, at least 30% of patients with epilepsy continue to have seizures despite optimal drug therapy.Intractable seizures: are defined as inadequate control of seizures despite treatment with conventional medications. Poorly controlled epilepsy has been associated with higher rates of mortality , unemployment and cognitive impairment.Modes of treatment include, medications, ketogenic diet, surgery and vagal nerve stimulation.Ketogenic diet is an old method for treatment of resistant epilepsy which has been successfully used in treatment of pediatric intractable seizures for more than seventy years and has been revived in recent years because of its proven efficacy.Ketogenic diet is a high fat, low carbohydrate and adequate protein diet which was calculated to provide appropriate calorie intake for growth and adequate calories.The mechanism of action of ketogenic diet remains a mystery. On ketogenic diet, the majority of patients reported improvement in seizure frequency and in their child behavior and functions.Throughout the diet, adjustments of the calories, protein content and volume of formula ware made according to growth increase.Reasons of failure include medical and non-medical causes ie; no compliance, vomiting and refusal of feeding.