Objective To analysis the long-term retention rate of Levetiraceram (LEV) monotherapy or combination therapy of infant epilepsy. Methods The clinical data of patients with infant epilepsy treated by LEV had been retrospectively analyzed from July 2006 to June 2007. Results Sixty patients with infant epilepsy treated by LEV had been recruited, 20 cases with partial seizures, 19 cases with generalized seizures, 21 cases with epilepsy syndrome. Among them 21 cases was intractable epilepsy. The retention rates of LEV in 6-month, 1-year, 2-year, 3-year and 4-year were 95.5%, 75.0%, 60.0%, 51.7%, and 38.3%. The most common reason for withdrawal was lack of effect (43.2%). COX regression model suggested that duration > 1 month (RR=2.91, 95% CI: 1.16~7.30) and refractory epilepsy (RR=2.30, 95% CI: 1.22~4.32) were risk factors of withdrawal (all P<0.05). After treatment, the seizure frequency significantly reduced compared with baseline (P<0.01). To the end of the follow-up, the efficiency was 100% and the complete remission rate was 69.57% in 23 cases continued treatment. The main side effect were fatigue (56.0%), and sleep increased, irritability, and so on. Conclusions LEV monotherapy or combination therapy has well long-term retention rate, maintains well efficacy and tolerability in infant epilepsy.