Anyone of appropriate age with epilepsy can marry as long as they meet the requirements of our marriage laws. It is advisable to consult a physician specializing in epilepsy and other related disciplines regarding genetic risks and the use of antiepileptic drugs before having children to minimize the probability of hereditary epilepsy, prevent fetal malformations, and ensure the delivery of a healthy baby. Genetic factors play an important role in the occurrence and development of epilepsy. Many inherited metabolic diseases due to genetic mutations can manifest with seizures, and genetic factors also play a very important role in primary epilepsy caused by unknown causes. Currently, many genes causing primary epilepsy and some genes for inherited metabolic diseases have been identified and studied. In the last 40 years, many research materials from domestic and international studies have confirmed that epilepsy does have a genetic predisposition. The prevalence of epilepsy in the general population is about 0.5%, while the prevalence in siblings of epileptics is 22.8%, parents 19.4%, their uncles, aunts and uncles 6.2%, grandparents 3.0%, and cousins 2.3%. Do people with a genetic predisposition always develop epilepsy? The genetic predisposition to epilepsy is based on the cumulative effect of many genes and is closely related to environmental factors, i.e., the onset of epilepsy is influenced by both genetic and environmental factors. This inheritance is a genetic disease caused by mutations in multiple genes on chromosomes, so that about 95% of people with a genetic predisposition will not develop epilepsy throughout their lives. Many studies of epilepsy genetics in the last decade have found that several Mendelian inheritances of primary epilepsy are due to alterations in ion channels, mainly potassium and sodium ion channel potential voltages. Examples include benign familial neonatal convulsions, benign familial infantile convulsions, autosomal dominant nocturnal frontal lobe epilepsy, generalized epilepsy with febrile convulsions addition, juvenile myoclonic epilepsy, benign childhood epilepsy with central temporal spikes, and childhood aphasic epilepsy. It is commonly believed that the onset of many types of epilepsy is the result of a combination of congenital genetic factors and acquired factors, with the exception of epilepsy due to monogenic inheritance. Special attention should be paid to the fact that if both parents are epileptic, there are statistics that the prevalence of epilepsy in their children is as high as 80%. If a child with epilepsy has already been born, a second child should be strongly prohibited. Some epilepsy can be prevented by taking proactive measures: genetic predisposition makes some children “susceptible” to convulsions, which can be triggered by various environmental factors. In this regard, the importance of genetic counseling is particularly emphasized. A detailed systematic family survey should be conducted to find out whether seizures and their characteristics are present in both parents, siblings and close relatives, and whether there is a history of febrile convulsions, and to predict the likelihood of siblings, offspring and other relatives. In families with certain severe genetic disorders causing mental retardation and epilepsy, prenatal diagnosis, or neonatal screening, should be performed as conditions permit to determine whether to terminate the pregnancy or treat it early. How can a woman with epilepsy get pregnant? Women with epilepsy who wish to have a normal, healthy child must choose to become pregnant during a period of relative stability; or be treated with medication in reasonable doses and with minimal side effects under the guidance of a physician, and develop the best plan for seizure control to try to prevent the birth of a malformed fetus. If seizures are still frequent after pregnancy, or even if persistent status epilepticus occurs, the pregnancy should be decisively terminated while treating the seizures to ensure the life of the pregnant woman as well as to avoid the birth of a malformed child.