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Objective To summarize the clinical and EEG features of patients with different ages of Rasmussen encephalitis to evaluate the efficacy of different surgical methods. Methods and Results According to the age of onset, the patients with Rasmussen encephalitis were divided into 2 groups, one group was under 6 years old (≤ 6 year group, n = 18), the other group was over 6 years old (> 6 year group, n = 18). The medial duration of advancing to actue phase was 5 (2, 11) months in ≤ 6 year group and 12.00 (5.50, 24.00) months in > 6 year group, respectively (P = 0.014). Nine months after onset, 15 cases advanced to acute phase in < 6 year group, and 6 cases advanced acute phase in > 6 year group (P = 0.006). EEG showed persistent/intermittent slow wave activity over the affected hemisphere (35 patients). Nine months after onset, 2 groups of patients with multi-region epileptiform discharges have advanced to acute phase from prodromal phase (10 cases in ≤ 6 year group and 2 in > 6 year group; P = 0.036). The prognosis of functional hemispherectomy was Engel I in 21/27 cases (11 cases in ≤ 6 year group and 10 in > 6 year group), anatomic hemispherectomy Engel I in 8/8 cases (4 cases in both ≤ 6 year group and > 6 year group, respectively). Conclusions The earlier the onset age of Rasmussen encephalitis patients, the faster the disease progresses. The EEG shows continuous slow wave and multi-epileptic discharge in the affected side hemisphere. Anatomic hemispherectomy and/or functional hemispherectomy still remains of be the only cure for the seizures caused by Rasmussen encephalitis. [ABSTRACT FROM AUTHOR]