Epilepsy is a common chronic disease of the nervous system, with a prevalence of about 7.0‰ and about 10 million epilepsy in China. Regular and rational antiepileptic drug therapy can prevent recurrence in 50%-90% of epilepsy patients. However, epidemiological data found that nearly 30% of patients with epilepsy achieve spontaneous remission without treatment. The most important concern for patients with epilepsy and their families is when they need to be treated with medication. Reasonable and timely medication is important to reduce the risk of seizure recurrence, improve the quality of life of patients with epilepsy, and reduce the side effects of antiepileptic drugs. AEDs are generally not recommended for patients with first non-induced epileptic seizures; however, if there is a clear etiology (including imaging abnormalities, neurological deficits, etc.), EEG abnormalities (especially focal abnormal epileptic waves), and first seizure onset as a persistent status epilepticus or cluster seizures, AEDs should be treated immediately. In addition, late age of onset, partial seizures, high number of seizures before treatment, multiple seizure types, seizures during sleep, positive family history, and previous induced epileptiform seizures (e.g., febrile convulsions) may be factors affecting seizure recurrence or prognosis, and AEDs should also be given in principle if the above risk factors, especially ≥2 risk factors, are present.