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 usually do not occur. The selection of patients for epilepsy surgery focuses 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 the seizures and the significance of the treatment; the availability of surgery depends mainly on the diagnosis of epilepsy and the accurate localization of the epileptic focus. 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. After determining that the epilepsy is occipital lobe epilepsy, submural fiber transection and thermal cautery of the epileptogenic cortex should be performed on the site of discharge concentration with intraoperative EEG monitoring, and if intraoperative review of cortical EEG spikes is still evident, excision of the cortex is chosen. If the cortical EEG before cautery shows an abnormal EEG background with significant spikes, especially in the non-dominant hemisphere, the cortical layer should be removed directly. In recent years, it has been suggested that localized isolated cerebral dissection has better results in terms of seizure control, preservation of brain function, and reduction of postoperative complications in patients with lesions located in the telencephalon and with a wide range of lesions or EEG abnormalities. In some patients, if the transmission of epileptic discharges to the temporal lobe or contralateral occipital lobe can be clearly identified, selective hippocampal amygdala resection or posterior corpus callosotomy via a lateral posterior approach is feasible to reduce or eliminate the possibility of transmission of epilepsy to the contralateral side.