Seizures after brain tumor surgery complicate the postoperative condition and affect the patient’s prognosis and increase the patient’s psychological burden, which is getting more and more attention from neurosurgeons. Because of the infiltration of glioma into the surrounding normal brain tissue, it is difficult to find a clear boundary for resection during surgery: it is difficult to ensure that the tumor tissue is completely removed if less is cut, and it is even more painful if more is cut, because it is the brain that concerns our intelligence, emotion, character and thinking, so how can we cut more just like that? As for high-grade glioma, its complete cure is even more difficult. After the tumor is removed, the shrinkage of the surrounding brain tissue, gliosis, and continued adhesions and scar formation cannot be eliminated, so some patients still have seizures after surgery, but the frequency and form of seizures change. Patients who did not have seizures before surgery can also develop seizures due to the presence of pathological changes such as brain parenchymal atrophy and gliosis due to surgical trauma and edema and ischemia of the surrounding brain tissue during tumor growth, neuronal metabolic disorders, and abnormal cell membrane depolarization processes. Eight percent of patients with a history of preoperative epilepsy develop late-onset epilepsy postoperatively. 59% of patients with multiple epilepsy and 64% of patients with late-onset epilepsy develop epilepsy within 6 months after craniotomy. It has been suggested that postoperative antiepileptic therapy in patients with glioma is often ineffective. Prophylactic treatment in patients without preoperative epilepsy should be discontinued after 6 months, and antiepileptic drugs with good efficacy and fewer adverse effects should be used in patients with a high risk of seizures.