The gold standard for the treatment of medically refractory temporal lobe epilepsy continues to be surgical resection. This technique is not significantly different from when it was first popularized by Wilder Penfield in 1952. Significant advances in treatment are limited by our understanding of the structural abnormalities within the hippocampus prior to resection. In addition, pre-surgical planning for minimized resection demand accurate localization of hippocampal sclerosis (HS), which is limited by the achievable neuroimaging resolution. With advances in structural and diffusion MRI, microstructural imaging of brain tissue in high resolution is made possible, which can aid pre-surgical planning.