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We aimed to relate hippocampal surface\u2010shape patterns to verbal and visual learning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed hippocampal surface shapes on high\u2010resolution magnetic resonance images and the Adult Memory and Information Processing Battery in 145 unilateral refractory TLE patients undergoing epilepsy surgery, a validation set of 55 unilateral refractory TLE patients, and 39 age\u2010 and sex\u2010matched healthy volunteers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both left TLE (LTLE) and right TLE (RTLE) patients had lower verbal (LTLE 44\u2009\u00b1\u200911; RTLE 45\u2009\u00b1\u200910) and visual learning (LTLE 34\u2009\u00b1\u20098, RTLE 30\u2009\u00b1\u20098) scores than healthy controls (verbal 58\u2009\u00b1\u20098, visual 39\u2009\u00b1\u20096; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Verbal learning was more impaired the greater the atrophy of the left superolateral hippocampal head. In contrast, visual memory was worse with greater bilateral inferomedial hippocampal atrophy. Postsurgical verbal memory decline was more common in LTLE than in RTLE (reliable change index in LTLE 27% vs RTLE 7%, <jats:italic>p<\/jats:italic> = 0.006), whereas there were no differences in postsurgical visual memory decline between those groups. Preoperative atrophy of the left hippocampal tail predicted postsurgical verbal memory decline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Memory deficits in TLE are associated with specific morphological alterations of the hippocampus, which could help stratify TLE patients into those at high versus low risk of presurgical or postsurgical memory deficits. This knowledge could improve planning and prognosis of selective epilepsy surgery and neuropsychological counseling in TLE. 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