Objective. The aetiology and pathogenesis of medial temporal lobe epilepsy (MTLE) remain unclear, and effective treatments are lacking. The involvement of a dysregulated competing endogenous RNA (ceRNA) network in MTLE is only partially understood. The purpose of this study was to investigate MTLE regulatory networks composed of messenger RNAs (mRNAs), circular RNAs (circRNAs), long non-coding RNAs (lncRNAs), and microRNAs (miRNAs) through a ceRNA network map. Methods. RNA sequencing (RNA-seq) and small RNA-seq were used to detect mRNAs, circRNAs, miRNAs, and lncRNAs differentially expressed between post-operation hippocampal tissues of MTLE patients (n = 3) and paracancer tissues (n = 3). We performed bioinformatics analysis to identify differentially expressed RNAs and construct the corresponding ceRNA network. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of differentially expressed RNAs were conducted to explore the biological processes and pathways involved in MTLE. Results. We identified 352 differentially expressed mRNAs, 179 circRNAs, and 42 miRNAs in MTLE. A ceRNA network composed of mRNAs, circRNAs, and miRNAs was constructed. GO and KEGG analysis of the network suggested a key role of synapses and mTOR, cAMP, ErbB, FoxO, and HIF-1 signalling pathways in MTLE. Significance. We identify a new circRNA-miRNA-mRNA ceRNA network in MTLE. These results can help clarify the aetiology of MTLE and identify targeted molecular therapies.