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Objective Explore neuropsychological and quality of life outcomes of epilepsy surgery in an underserved, primarily immigrant, Spanish-speaking cohort of people with epilepsy (PWE). Methods Pre- and postsurgical Neuropsychological Screening Battery for Hispanics (NeSBHIS) and Quality of Life in Epilepsy-31 (QOLIE-31; Spanish Version) results were compared for 22 adult Latinos (females = 50%), from Mexico (81.8%), El Salvador (9.1%) and Guatemala (9.1%). All participants were part of a comprehensive epilepsy center in Los Angeles. Mean surgical age was 33.5 years (SD = 8.5), while mean education was 8.7 years (SD = 3.1). Seizures were exclusively lateralized to right (59.1%) and left hemispheres (40.9%). Results One-tailed, paired t-tests demonstrated statistically significant differences between pre- and postsurgical raw scores for Digit Span, t(21) = -2.52, p = 0.02 (presurgical M = 8.05, SD = 1.70; postsurgical M = 7.32, SD = 1.43), and the Auditory Verbal Learning Test (AVLT) Delayed Recall, t(21) = -2.99, p < 0.01 (presurgical M=10.00, SD=2.51; postsurgical M = 8.55 SD = 2.61). Respective effect sizes were moderate (d =.54; d =.64). QOLIE-31 scores improved on all subscales, as expected. Significant changes |p < 0.05| were found on most QOLIE-31 subscales, i.e. Seizure Worry, Emotional Well-Being, Social Function and Overall Quality of Life. Remaining subscales did not significantly improve, i.e. Energy/Fatigue, Cognitive and Medication Effects. Conclusions Attention and verbal memory declines after epilepsy surgery were associated with limited improvements on QOLIE-31 subscales of Cognitive, Energy/Fatigue and Medication Effects in Latino PWE. Previous studies have not simultaneously examined neuropsychological and QOLIE-31 outcomes after epilepsy surgery in this unique, underserved, Spanish-speaking population. Further investigation is warranted. [ABSTRACT FROM AUTHOR]