The most common sexual abnormality in temporal lobe epilepsy is a marked lack of libidinal and genital arousal. The author documents the occurrence of hypersexual behavior in 50 temporal lobe epileptics, 42 of whom had unilateral temporal lobectomy. Twenty-nine (58 percent) were clearly hyposexual prior to surgery; seven (14 percent) had distinct episodes of hypersexuality. In six patients the hypersexual episodes followed the abrupt cessation of temporal lobe seizure activity following either temporal lobectomy or seizures. These findings document the role of the temporal limbic structures in the regulation of sexual arousal.