Guidelines for epilepsy recommend timely referral of potential surgical candidate to an epilepsy center for evaluation. However, many patients are never referred for evaluation, or referred even a few decades after medically intractable condition. Physician's negative attitudes toward surgery may increase risk of morbidity and mortality in epilepsy patients. The aim of this review is to identify barriers toward epilepsy surgery among physicians. Importance of long-term epilepsy monitoring is emphasized.