Objective To investigate the gray matter volume (GMV) changes in patients with temporal lobe epilepsy using voxel-based morphometry method. Methods Whole brain 3D structural images were acquired in 22 patients with pathologically confirmed temporal lobe epilepsy and 15 gender and age matched healthy controls. Comparison of GMV between the two groups was analyzed by VBM toolbox of statistical parametric mapping 8. Results Compared with the controls, the left temporal lobe epilepsy patients showed decreased GMV in right anterior lobe of cerebellum, left middle temporal gyrus, left inferior temporal gyrus, left middle occipital gyrus, left inferior frontal gyrus, right inferior frontal gyrus, right middle temporal gyrus, left hippocampus, left superior frontal gyrus, right caudate lobe, right middle frontal gyrus, left postcentral gyrus, right precentral gyrus (P<0.05). The right temporal lobe epilepsy patients showed decreased GMV in right inferior temporal gyrus, right middle temporal gyrus, left lingual gyrus, left inferior occipital gyrus, left superior temporal gyrus, left parahippocampal gyrus, right thalamus, left occipital gyrus, left middle temporal gyrus, right superior frontal gyrus, left precentral gyrus, left postcentral gyrus, right precentral gyrus (P<0.05). Conclusion The GMV decreased in patients with the temporal lobe epilepsy in multiple brain areas, Voxel-based morphometry can reveal GMV changes.