Background: Although the history of the ketogenic diet dates back centuries, with the advancement of anti-seizure medications, the use of the diet for epilepsy declined. It was not until the early 1990s that there was a resurgence of the diet as an adjunct therapy to anti-seizure medication. In 1998, the Montreal Children’s Hospital introduced the ketogenic diet to a child with drug resistant epilepsy. Shortly after, a presentation of the ketogenic diet at hospital Grand Rounds met much skepticism. However, over time the diet has developed into a well-established treatment option for children with drug resistant epilepsy. Two hundred children have since utilized the diet at the Montreal Children’s Hospital. Methods: A review of patient files since the initiation of the program was undertaken. Data was extracted regarding adverse effects, common errors in both hospital and home setting, risks for unfavorable outcomes and parental concerns Results: The development of a rigorous protocol has reduced potential adverse effects, inadvertent complications from errors have improved and parent satisfaction enhanced. Conclusions: This poster will demonstrate how an interdisciplinary approach for a ketogenic diet protocol, involving an advanced Practice Nurse, nutritionist, neurologist and parent, resulted in improved care.