Recognition memory performance of 91 left and right unilateral temporal lobe epilepsy (TLE) patients was examined prior to and post anterior temporal lobectomy. The left TLE group showed more impaired response discrimination ability than the right TLE group; however, their false positive rate varied as a function of distractor type. Prior to temporal lobe resection, false positives were higher for semantically related distractors (novel or from an interference list) than for semantically unrelated items from an interference list, phonemic distractors, or unrelated errors. Following temporal lobe resection, only novel semantically related distractors in the left TLE group showed a significant increase in false positives, and they were also significantly higher than all other error types. The results of this study suggest that the left TLE patients have impaired individual item recollection in the context of intact information about basic semantic attributes.