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 types of encephalitis, birth injuries, or having congenital genetic disorders, can almost always lead to mental retardation; primary epilepsy, about 1/3 can have some degree of cognitive impairment. 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%. The literature reports that most of the severe cognitive impairment in children with epilepsy is caused by multiple drugs. Therefore, in epilepsy treatment, it is important to weigh the advantages and disadvantages of choosing the variety of drugs, both to achieve better therapeutic effects and to minimize the impact of drugs on the child’s intelligence, and to advocate monotherapy. Finally, it should be noted that although there is no clinical cure for epilepsy and the factors of intellectual development are not yet fully understood; we can still minimize the appearance of mental retardation or reduce its impairment by controlling the relevant damaging factors, such as carrying out genetic counseling and good prenatal and maternal health care to reduce the occurrence of congenital genetic disorders. For children who have been diagnosed, early, rational, and standardized treatment should be given, and striving to control seizures within a short period of time can greatly reduce the likelihood of mental retardation. If seizures are short-lived and can be effectively controlled with medication, most of them will not affect 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 become stupid not as a result of treatment medications, but as a result of persistent seizures. It has been found that both children with epilepsy who undergo surgery and have effective postoperative control of their condition have generally improved their IQ compared to their preoperative status, according to uniform national and international standards.