We report the cases of 10 patients with seizures and autoscopic phenomena, which include seeing one's double and out-of-body experiences, and review 33 additional cases of autoscopic seizures from the literature. Autoscopic phenomena may be symptoms of simple partial, complex partial, or generalized tonoclonic seizures. Autoscopic seizures may be more common than is recognized; we found a 6.3% incidence in the patients we interviewed. The temporal lobe was involved in 18 (86%) of the 21 patients in whom the seizure focus could be identified. There was no clear lateralization of lesions in patients with ictal autoscopy. The response of autoscopic episodes to treatment usually paralleled that of the underlying seizure disorder. Autoscopic phenomena are likely to be discovered only on specific questioning of patients with epilepsy and may be an important, distressing feature of a chronic seizure disorder.