Glioma is difficult to treat and epilepsy is not well treated. What happens when both are present at the same time? There are two main causes of tumors that trigger epilepsy. The first is due to the location of the glioma growth, or growing larger and larger, compressing the functional areas of the brain, causing abnormal discharges of neurons in the brain and thus manifesting symptoms of epilepsy. This kind of epilepsy symptoms will appear before surgery, but through surgery, most patients’ epilepsy symptoms will disappear; some other patients still have seizures after surgery and need to continue taking antiepileptic drugs. The second type is those who did not have seizures before surgery but developed them after surgery, which is further divided into two cases. One type of epilepsy appears very early after surgery, which may be caused by edema and bleeding of the local lesion after surgical removal of the tumor. Patients should wait for the edema and bleeding to be absorbed on one hand, and on the other hand, they can consult the doctor to use the appropriate antiepileptic drugs. The other type of epilepsy that occurs only a few months after surgery is due to scar formation in the brain area where the tumor was removed, and as the scar grows, it can also lead to epilepsy, and this is also the time to consult a doctor for antiepileptic drugs. If the epilepsy cannot be controlled even with medication, surgical treatment should be considered. Both of these categories can be attributed to perioperative epilepsy, which occurs in up to 30 percent of cases. The emergence of secondary epilepsy halfway through the treatment of glioma can be a real concern. How can we deal with this “roadblock”? In fact, the best thing to do is to prevent epilepsy in advance. In general, the lower the grade of the glioma, the more likely it is to develop epilepsy because of the irritation of the lesion; those with high grade glioma, because the cells in the lesion area are often destroyed, the chance of epilepsy is smaller, or the seizures are not typical. If epilepsy is present before surgery, then for gliomas with secondary epilepsy, especially those with secondary epilepsy only, the prognosis is relatively good, and complete resection of the foci of origin can be done at the same time as removal of the glioma in order to achieve the possibility of eradication of both.