ObjectiveTo evaluate the role of several examinations in the presurgical localization of insular/peri-insular cortex epilepsy (IPICE). MethodsThe data of patients with IPICE who were identified by resective surgery from 2011.1 to 2015.4 were retrospectively analyzed. The role of semiology, scalp EEG, MRI and magnetoencephalography (MEG)in the localization of epileptogenic zones for patients with IPICE were evaluated. Results18 patients were selected according to the criteria. The localization of IPICE was supported by semiology in 16 patients, supported by MRI in 6 patients, supported by MEG in 17 patients. In 12 patients with negative MRI, the dipoles were showed in insular/peri-insular area in 11 patients. The localization role of MEG for patients with IPICE is more obvious than that of MRI (P < 0.05). The MEG result played conclusive role in 9 patients. According to result of MEG, the plans of intracranial recording were canceled in 3 patients, and the plans of intracranial electrodes implanting were modified in 5 patients. The resective surgery involving the insular/peri-insular cortex was performed in all the 18 patients. During the follow-up of 12~48 months, seizure-free was reported in 11 patients, although 2 patients were missed. ConclusionThe combination of the results of semiology, scalp EEG, MRI and MEG was helpful in the localization of epileptogenic zones for patients with IPICE, and MEG played a valuable role in this localization.