Although our neurosurgeons have made great achievements in the surgical treatment of epilepsy, there are still many aspects that need to be improved and improved. We should not miss the appropriate time for surgical treatment because we are overly worried about various side effects after surgical treatment, and we should not arbitrarily expand the indications for surgery. In some hospitals, not only physicians, but also some neurosurgeons, still have a rather stereotypical understanding of epilepsy. For example, they think that “epilepsy can only be treated by medication” and “removing the lesion is the treatment of epilepsy”. We need to clarify the concept that a lesion is not necessarily an epileptogenic lesion, and removing a lesion does not necessarily control epilepsy. Only when the epileptogenic zone is removed can the seizures be controlled. For some patients who are suitable for surgical treatment, if they do not receive timely surgical treatment, even if the seizures are controlled by surgery at a later stage, it is difficult to solve the physical and psychological disorders caused by long-term seizures. Of course, not all epilepsy patients need surgical treatment, and patients who need surgical treatment only account for a portion of epilepsy patients, so what kind of epilepsy patients are suitable for surgical treatment? The scientific grasp of the indications for surgical treatment of epilepsy is crucial, and the selection of patients for surgery can be very tricky for neurosurgeons. For example, is surgery an option when the epileptogenic zone causing the seizure has not been fully identified or when there are multiple, extensive epileptogenic zones in the brain, and what kind of surgery is chosen? These are some very sensitive issues. With reference to foreign experience and combined with the actual situation in China, most scholars believe that the following points should be considered in the surgical treatment of epilepsy: 1. Refractory epilepsy, where first-line antiepileptic drug system and regular treatment for more than 2 years are ineffective should be entered for surgical evaluation. Of course, for progressive epilepsy syndromes and drug-refractory medial temporal lobe epilepsy in adolescents caused by hippocampal sclerosis, as well as for epilepsy with clear organic lesions such as brain tumors, cerebrovascular malformations, and traumatic brain scarring, more aggressive surgical treatment should be performed, without the need to adhere to the limit of no less than 2 years of formal drug therapy. 2.The origin of seizures, i.e., the epileptogenic zone, which is not widespread but more limited, can also be considered for surgical treatment. 3, While obtaining clear surgical treatment results, the postoperative period does not cause important functional deficits. The above points can be used as important reference points for epilepsy patients to decide whether to have surgical treatment. Of course, surgery cannot be performed for those with underlying degenerative or metabolic diseases, as well as those with combined severe systemic diseases that cannot tolerate surgery, combined with severe mental disorders and cognitive dysfunction.