Objective To retrospectively analyze the effect and safety of bilateral stereotactic radiofrequency amygdalohippocampectomy (SAHE) for treatment of bilateral medial temporal lobe epilepsy (BMTLE). Methods Twelve BMTLE patients were treated with bilateral SAHE under limited coagulations. Clinical parameters were evaluated with the programs of Engel′s classification, Liverpool Seizure Severity Scale (LSSS) 2.0, Wechsler Adult Intelligence Scale-Revised (WAIS-R) and Wechsler Memory Scale-Revised (WMS-R), respectively. Results Five patients (42%) were assessed as EngelⅠwith 12 ~ 62-month follow-up. Seizure severity scores were declined sharply compared with the baseline of the patients with out seizure free. Function of memory and intelligence was transiently declined without statistical significance immediately after operation (P >0.05), but was significantly increasedat 6 months after operation (P < 0.05). Conclusion Bilateral SAHE could terminate seizures or reduce seizure severity in patients with BMTLE. Under the circumstance of limited coagulations, neuropsychological function was improved along with seizure control.