To present our experience with vagus nerve stimulation (VNS) and to evaluate the long-term efficacy and safety of the procedure in pediatric intractable epilepsy. This study included sixteen patients, who were implanted with a vagus nerve stimulator and could be followed up for at least more than 12 months in two epilepsy centers. Data including seizure frequency, EEG, quality of life measures and adverse events were prospectively filed over a 5-year period. VNS resulted in a >50% reduction in seizure frequency in 50.0% (8/16) of children with 31.3% (5/16) of patients achieving a >90% reduction. Additionally, enhancements in quality of life were as follows: memory in 50.0% (8/16), mood in 62.5% (10/16), behavior in 68.8% (11/16), alertness in 68.8% (11/16), achievement in 37.5% (6/16), and verbal skills in 43.8% (7/16) of the patients. Adverse events included hoarseness in two patients, dyspnea during sleep in two patients, and sialorrhea in one patient. However, these events were tolerable or could be controlled by the adjustment of output currents. In one patient, wound revision was required. Our data supports the role of VNS as an alternative therapy for pediatric intractable epilepsy.