Epilepsy is a common disease of the nervous system, and the prevalence of epilepsy in China is (4-7)/1000. Many studies have shown that the likelihood of epilepsy occurring in the offspring of epileptic patients is higher than normal people, i.e., epilepsy has a certain genetic predisposition. The prevalence of close relatives in patients with idiopathic epilepsy is 2-6%, which is significantly higher than the general population. There are different modes of inheritance, such as autosomal dominant for childhood-onset epilepsy and autosomal recessive for idiopathic infantile spasms. Genetic factors only influence epilepsy susceptibility and onset is influenced by episodic rates, e.g. more than 40% of siblings of children with childhood atonic epilepsy have the same EEG abnormalities between the ages of 5 and 16 years, but only ¼ develop clinical seizures. Although epilepsy has a genetic predisposition, the vast majority of people with epilepsy can still have children, but it is just more important for people with epilepsy to pay attention to eugenics. Patients with a clear family history of epilepsy can undergo genetic diagnosis to find the type of genes that cause the disease to clarify whether fertility is possible. In addition, patients with epilepsy should avoid choosing a spouse who also has epilepsy to avoid increasing the incidence of their children. For female patients, family planning should be done after the seizure symptoms are fully controlled and antiepileptic drug therapy is gradually reduced to the lowest maintenance dose or discontinued for at least six months to ensure that the harmful effects of antiepileptic drugs on the fetus are minimized. In summary, epilepsy has a certain genetic predisposition, and patients with epilepsy should seek genetic counseling at a professional institution to enhance pregnancy monitoring if they require fertility.