Epidermoid tumors form nearly 1% of spinal neoplasms and 0.2% to 1.8% of intracranial neoplasms. Intracranial epidermoids are most often located in the cerebellopontine angle, and supratentorial locations are relatively rare. We reviewed our single-institution experience of having treated 32 patients with supratentorial epidermoid tumors with an intention to contribute to the general body of knowledge of these tumors. The clinical profile, imaging characteristics, management options, and long-term outcomes were analyzed retrospectively and compared with the available literature. Supratentorial epidermoids commonly present with seizures closely followed by headache. Diffusion-weighted imaging magnetic resonance imaging is an important imaging tool both in the diagnosis and in the early detection of recurrences. Attempts at total excision can result in serious complications, especially in areas where the capsule is densely adherent to major neurovascular structures. The long-term functional outcome is not influenced by the extent of excision. Surgery should therefore aim at providing maximum tumor clearance without producing any new deficits. Copyright © 2012 by Lippincott Williams & Wilkins.