OBJECTIVE To study and compare the clinical and electroencephalography (EEG) features in children with benign occipital epilepsy (BOE) of Gastaut and Panayiotopoulos types. METHODS The clinical data of 23 children with BOE (16 Gastaut type and 7 Panayiotopoulos type) were retrospectively studied. RESULTS The mean age of onset in the Panayiotopoulos and Gastaut groups were 4.5 and 9.1 years, respectively. The children in the Panayiotopoulos group were characterized by ictal vomiting, frequent deviation of eyes and head, frequent nocturnal seizures, and secondary generalized seizures with longer duration but less frequency. By comparison, the children in the Gastaut group were characterized by visual symptoms as ictal events, higher seizure frequency, shorter seizure duration and more frequent diurnal seizures. The EEG showed that the majority of both groups had occipital spike-wave discharges when the eyes were opened. Eleven children in the Panayiotopoulos group and all of 7 children in the Gastaut group received antiepileptic mono-drug therapy. All of the 11 children in the Panayiotopoulos group responded to the therapy, but 2 cases in the Gastaut group did not respond and 2 cases had subtle cognitive deficits. CONCLUSIONS There are differences in the age of onset, clinical symptoms, seizure frequency and duration, and therapeutic responses between children with Panayiotopoulos and Gastaut type BOE.