Preface: Epilepsy is one of the common neurological disorders in children, and oral antiepileptic drugs are the main treatment for most children with epilepsy. The principle of drug therapy is to standardize the selection of appropriate drugs according to the type of seizure and classification of epilepsy syndrome. The concept of long-term management of childhood epilepsy is to focus on the whole process of treatment, in which the initial selection of medication is crucial, and the efficacy and safety of antiepileptic drugs should be balanced to improve the long-term treatment retention rate. In order to improve the standardization of medication use in childhood epilepsy in China, the Expert Consensus on Initial Monotherapy for Newly Diagnosed Childhood Epilepsy was published by the Neurology Group of the Pediatrics Branch of the Chinese Medical Association, published in the October 2015 issue of the Chinese Journal of Pediatrics, and is summarized below. Initial monotherapy options for children with newly diagnosed generalized seizures VPA is the only initial monotherapy drug of choice for the five seizure types: generalized tonic-clonic seizures, tonic seizures, clonic seizures, myoclonic seizures, and atonic seizures. The initial monotherapy drugs of choice for atonic seizures are VPA and ESM. First-line drugs for generalized tonic-clonic seizures, tonic seizures, and clonic seizures are VPA and LEV; LTG is also the first-line drug of choice for generalized tonic-clonic seizures and tonic seizures. The first choice and first-line drug for atonic seizures is VPA. The first-line drugs for myoclonic seizures are VPA, LEV and TPM. The first-line drugs for atonic seizures are VPA, ESM and LTG. Initial monotherapy selection in children with newly diagnosed focal and special seizure types The initial monotherapy drug of choice in children with newly diagnosed focal seizures and focal seizures secondary to generalized seizures is OXC The first-line drugs were OXC, CBZ, LEV, VPA, and LTG. The initial monotherapy drug of choice in children with epilepsy with epileptic spasms, multiple seizure types (those with multiple seizure types that cannot be diagnosed as any epilepsy syndrome), and difficult-to-type seizures (those with other seizures that cannot be distinguished from focal seizures, generalized seizures, or epileptic spasms) were all VPA, and their first-line drugs are VPA and TPM; first-line drugs for epileptic spasms are also VGB, and first-line drugs for multiple types of seizures and difficult-to-type seizures are also LEV. Initial monotherapy options for newly diagnosed common childhood epilepsy syndromes Lennox-Gastaut syndrome, Doose syndrome, Landau-Kleffner syndrome, persistent spiking with slow-wave sleep phase In addition, TPM and prednisone can also be used as first-line agents in Lennox-Gastaut syndrome and Landau-Kleffner syndrome, respectively. Kleffner syndrome. The initial monotherapy drugs of choice for childhood aphasic epilepsy are VPA and ESM, and the first-line drugs are VPA, ESM, and LTG. The initial monotherapy drug of choice for benign epilepsy with central temporal spikes is OXC, and the first-line drugs are OXC, LEV, VPA, and CBZ. The initial monotherapy drug of choice for infantile spasms is ACTH, and the first-line drugs are ACTH, TPM, prednisone, VGB, and VPA. In infantile spasms with tuberous sclerosis, the initial monotherapy drug of choice is VGB and ACTH, and the first-line drugs are VGB, ACTH, TPM, and VPA. No appropriate initial monotherapy drug of choice is recommended for Ohtahara syndrome and Dravet syndrome, and the first-line drugs for both are VPA and TPM; LEV is also available for Dravet syndrome as a first-line drug.