Hypothalamic hamartoma (HH) is an uncommon intrinsically epileptogenic lesion of the hypothalamus that is associated with medically intractable epilepsy. Intractable seizures caused by HH may lead to progressive cognitive delay and are also associated with generation of secondary epileptic foci. Therefore, early referral and surgery for children with HH is critical. Recent advances in minimally invasive neurosurgical techniques, including endoscopy, radiosurgery, magnetic resonance-guided laser interstitial ablation, and deep brain stimulation, have increased both the variety and feasibility of treatment options available for treating the intractable seizures caused by HH. In this manuscript, we review emerging techniques available for treatment of intractable seizures associated with HH.