Objective　Analyze and summarize the clinical and EEG characteristics of 3.0 T MRI-negative adult patients with epilepsy，to provide a basis for improving the etiology of MRI-negative adult patients with epilepsy. Methods　Review the clinical data of patients with epilepsy diagnosed and treated in our hospital from September 2016 to June 2019，aged ≥16 years old and with a cranial 3.0T MRI result normal，combined with relevant literature，to summarize and analyze MRI-negative adult epilepsy patients Clinical and EEG characteristics，to explore possible potential causes. Results　134 MRI-negative adult epilepsy patients had the most common onset at 18～60 years old，accounting for 64.18%，37.31% of patients had a traceable etiology；50.75% of patients had clear aura symptoms before onset，and the specific aura symptoms were significantly higher than non-specific aura symptoms. The seizure type was most common with focal origin；82.10% of patients were treated with standardized AEDs，and the effective rate was 67.27%；68.18% of them were monotherapy，with a total effective rate of 54.54%. The positive rate of epilepsy detected by video-EEG was 62.69%. Intermittent abnormal discharges were most common in the temporal region，accounting for 40.48%，and were mostly were unilateral. Conclusion　MRI-negative adult epilepsy is more common in young and middle-aged patients，and it is mostly of focal origin. The temporal lobe epilepsy has the highest proportion. The potential etiology is complex and diverse. regular anti-epileptic treatment should be used，and immunization and multimodal imaging should be completed as soon as possible to find the cause of intervention.