Epilepsy has a large effect on higher neurological functions and can cause mental retardation in particular. According to a domestic epidemiological survey, among 85,170 children aged 0-14 years, 294 cases of epilepsy were detected, with a prevalence of 3.45%, including 99 cases of mental retardation, accounting for 33.7%. This indicates that the prevalence of mental retardation is relatively high among children with epilepsy. Mental retardation in children with epilepsy depends mainly on the degree of brain damage, and an important cause of mental retardation in children with epilepsy is its primary cause. Cognitive impairment in children with epilepsy is also related to the type of epilepsy, seizure frequency and duration, EEG, and antiepileptic drugs. The main types of epilepsy and factors affecting the intelligence of children with epilepsy are: secondary epilepsy, such as various kinds of encephalitis, birth injuries, or having congenital genetic disorders, can almost always lead to mental retardation; primary epilepsy, about 1/3 of which can develop mental retardation. According to the literature, cognitive impairment in children with epilepsy is also related to the type of epilepsy, with the highest percentage of small motor seizures with mental retardation, 59.3%, and the lowest percentage of atonic small motor seizures, 10%. Therefore, in the treatment of epilepsy, it is important to weigh the advantages and disadvantages of choosing the type of drug to achieve a better therapeutic effect and to reduce the degree of impact of the drug on the child’s intelligence as much as possible, and to advocate monotherapy. Finally, it is important to note that there is no clinical cure for epilepsy, so the factors that prevent mental development are well understood and can be controlled to minimize mental retardation, such as genetic counseling, prenatal and maternal health care, and reducing the occurrence of congenital genetic disorders. For children with diagnosed epilepsy, early and reasonable regular treatment is required to control seizures in the short term, thus greatly reducing the likelihood of mental retardation. If the seizures themselves are brief and effectively controlled with medication, they will not affect the child’s intelligence. However, once seizures are repeated, especially if there is a persistent state, the brain is continuously deprived of oxygen and neuronal destruction increases, so that intelligence may be affected. Some children who become stupid are not caused by treatment medications, but are caused by the persistence of epilepsy. It has been found that according to uniform national and international standards, pediatric epilepsy patients who undergo surgery and have their condition effectively controlled postoperatively generally have increased IQ compared to preoperative levels.