Abstract: Objective To investigate the efficacy of topiramate in the treatment of children with epilepsy and evaluateits effect on serum glucose,insulin,cortisol,leptin,ghrelin and neuropeptide-Y levels and body mass index. Methods Total 20 cases of pediatric epilepsy in our hospital from October 2011 to October 2013 were retrospectively analyzed.All children were treated with topiramate at a daily dose of 5 mg/kg.Before and after the treatment,the fasting blood glucose,insulin and serum leptin,neuropeptide-Y,ghrelin,cortisol,and BMI levels were detected. Results After 3 months treatment,insulin level and body mass index levels were (4.65±2.28) μU/ml and (15.87±1.90) kg/m²,which were significantly lower than those before the treatment[(5.83±2.72) μU/ml and (16.44±1.84) kg/m²],P<0.05.But after 6 months treatment,the insulin level increased as compared with those values after 3 months treatment,and the results had no significantly difference when compared with those values before the treatment(P>0.05).After 6 months treatment,the serum cortisol and leptin levels were (10.13±4.17) μg/dl and (2.14 ±2.03) ng/ml,which were significantly lower than those before the treatment [(13.25±5.50) μg/dl and (2.89±2.63) ng/ml],P<0.05.Before and after the treatment,there were no significant differences on serum glucose,ghrelin or neuropeptide-Y levels. Conclusion In treatment of children with epilepsy,topiramate can reduce serum leptin and cortisol levels,which might be the key reasons of the decrease of body mass index.