Occipital lobe epilepsy presents as a group of syndromes including vegetative dysregulation such as vomiting, behavioral abnormalities, eye deviation, and impaired consciousness, which may be followed by generalized convulsive seizures. Early onset of seizures may be characterized only by pallor, sweating, and other vegetative symptoms, with or without behavioral disturbances. Ophthalmoplegia and vomiting are present in most seizures but can be absent. In a few cases, the seizures are atypical, such as eyes open, no eye deviation, self-induced discomfort, nausea or coughing without vomiting, quietness without agitation, and redness without pallor. Urinary and fecal incontinence and dilated pupils may occur. Visual hallucinations, mouth and throat movements, and automatisms do not usually occur. The selection of patients for epilepsy surgery is based on whether the patient needs surgery and whether surgery is possible. The need for surgery includes three aspects: the ineffectiveness of regular drug treatment (including the duration of the disease and regular medication), the degree of danger to the patient from seizures, and the significance of treatment; whether surgery is possible depends on the diagnosis of epilepsy and the accurate localization of the epileptic focus. The surgical procedures for occipital lobe epilepsy can be broadly divided into two categories: those that deal with the site of origin of the epilepsy and those that deal with the transmission pathway of the epilepsy, i.e., blocking its conduction pathway. If the epilepsy is identified as occipital lobe epilepsy, submural fiber transection and thermal cautery of the epileptogenic cortex should be performed under intraoperative EEG monitoring. If the cortical EEG before cautery shows an abnormal EEG background with significant spikes, the cortical layer should be removed directly, especially in the non-dominant hemisphere. In recent years, it has been suggested that localized isolated cerebral dissection is more effective in controlling epilepsy, preserving brain function, and reducing postoperative complications in patients with extensive lesions or EEG abnormalities located in the telencephalon. In some patients, if the transmission of epileptic discharges to the temporal lobe or contralateral occipital lobe is clear, selective hippocampal amygdala resection or posterior corpus callosum dissection via a lateral posterior approach is feasible to reduce or eliminate the possibility of contralateral transmission of epilepsy.