Background: Clinical studies have shown that prolonged seizures result in increased cytokine production in the central nervous system. Aim of work: To focus on diagnostic value of interleukin-1 receptor antagonists in refractory epilepsy. Patients and methods: This case-control investigation was done in Pediatric Neurology Unit and Pediatric Neurology Clinics, Faculty of Medicine, Zagazig University. Children were classified into: patient group: 59 children with refractory epilepsy aged between 1 year and 16 years old and control group: 59 healthy children who are age and sex corresponded to the patient population. Serum level of IL-1Ra was assessed. Results: There is significant higher value of plasma of interleukin1 receptor antagonist in studied refractory epilepsy group compared to the healthy control group. Conclusion: Interleukin-1 receptor antagonist can differentiate the control group and the seizure group.