: there is increasing evidence of a complex relationship between epilepsy and the immune system. Objective: The aim of this study was to determine that there is a chronic inflammatory process underlying pathophysiology of refractory epilepsy by determining the level of interleukin-6 (IL-6) in patients with refractory epilepsy and its relation to different poor prognostic factors that predict refractoriness. Patients and methods: this study was conducted on 80 patients with refractory epilepsy and 80 healthy control participants. All patients were assessed using detailed clinical history, examination, routine laboratory tests, C reactive protein, brain imaging, Video electroencephalography and IL-6 level in serum.