Infantile spasms is a specific type of epilepsy syndrome in infancy, characterized mainly by onset within 1 year of age, uncontrollable spastic seizures, psychomotor developmental delays, and peak EEG dysrhythmias. The peak age of onset is 3 to 5 months, and seizures are likely to occur when sleepy or just waking up. Each seizure lasts for a few seconds and occurs in strings, with as few as 3 to 5 seizures per string and as many as hundreds. The typical peak dysrhythmias are characterized by chaotic bilateral asymmetric asynchronous high-amplitude spikes and slow waves or multifocal spikes and slow waves, which are apparent during sleep. In addition, the EEG of a small number of children may also show spikes and slow waves without peak arrhythmias, but only spikes and slow waves with high amplitude. The long-term prognosis of the disease is poor, with 80% to 90% of children having psychomotor developmental stagnation or regression after the onset of the disease, and about 70% of children developing severe mental retardation, which brings a heavy burden to the family and society. There is no uniform treatment plan for infantile spasms. Antiepileptic drugs, immunoglobulins, high-dose vitamin B6, ACTH, and ketogenic diet can be tried in the treatment of infantile spasms. The mechanism of ACTH for infantile spasms is unclear. It has been suggested that adrenocorticotropin-releasing hormone (CRH) may be a pro-convulsant within the central nervous system, that the number of CRH receptors in the brain is high during infancy, that the concentration of CRH in the brain is significantly elevated during infantile spasms, and that exogenous ACTH may act by inhibiting the secretion of CRH from the hypothalamus. A recent study found that it may also be related to the inhibition of excitatory amino acids. Treatment of infantile spasms should be started as early as possible, and should try to be treated within 1 month after the onset of the spasms, which not only helps to control the spasms as soon as possible, but also reduces the impact of frequent spasms on intelligence and improves the quality of life.