Refractory epilepsy is not easy to treat. Different seizures and epilepsy syndromes have different clinical features and prognoses, and even patients with the same epilepsy syndrome have different prognoses. About 1/3 or so of patients with epilepsy can achieve long-term remission after a period of monotherapy, or even without treatment in a small percentage of patients. Another about 1/3 of patients can effectively control their seizures with monotherapy or reasonable multi-drug combinations and achieve satisfactory outcomes. Therefore, about 70% of patients with epilepsy have a good prognosis. Despite rational drug therapy, another 30% of patients still have prolonged seizures, which is called refractory epilepsy. Refractory epilepsy has become a major focus of epilepsy treatment, prevention, and research because it may cause intellectual and physical damage and bring a series of psychological and social problems. Refractory epilepsy should be recognized at an early stage so that more aggressive treatment measures can be applied as early as possible.