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We identified determinants of unaided walking, voluntary grasping with the hemiplegic hand, and speaking through Bayesian multivariable regression modeling using missing data imputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010five percent of children were seizure\u2010free, and 44% stopped antiseizure medication at a 5.1\u2010year mean follow\u2010up (range\u2009=\u20091\u201317.1). Seventy\u2010seven percent of children could walk unaided, 8% could grasp voluntarily, and 68% could speak at the last follow\u2010up. Children were unlikely to walk when they had contralateral magnetic resonance imaging (MRI) abnormalities (40\/73, <jats:italic>p<\/jats:italic>\u2009=\u20090.04), recurrent seizures following hemispherotomy (62\/109, <jats:italic>p<\/jats:italic>\u2009=\u20090.04), and moderately (50\/61, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) or severely impaired (127\/199, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) postsurgical intellectual functioning, but were likely to walk when they were older at outcome determination (<jats:italic>p<\/jats:italic>\u2009=\u20090.01). Children were unlikely to grasp voluntarily with the hand contralateral to surgery when they had Rasmussen encephalitis (0\/61, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) or Sturge\u2013Weber syndrome (0\/32, <jats:italic>p<\/jats:italic>\u2009=\u20090.007). Children were unlikely to speak when they had contralateral MRI abnormalities (30\/69, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and longer epilepsy duration (<jats:italic>p<\/jats:italic>\u2009=\u20090.01), but likely to speak when they had Sturge\u2013Weber syndrome (29\/35, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), were older at surgery (<jats:italic>p<\/jats:italic>\u2009=\u20090.04), and were older at outcome determination (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Etiology and bilaterality of structural brain abnormalities were key determinants of functional outcome after hemispherotomy. Longer epilepsy duration affected language outcomes. Not surprisingly, walking and talking ability increased with older age at outcome evaluation. 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