Epilepsy is the second most common neurological disorder in developed countries. Recent advances in the understanding of pathogenetic mechanisms and in the diagnosis and management of epilepsy over the past decade have had a significant impact on every aspect of epilepsy management. A simple diagnosis is inadequate for both patients and physicians. A full diagnostic investigation to classify the type of epilepsy is now mandatory for appropriate care. In this review, current views on pathogenetic mechanisms, controversies in classification, advances in neuroimaging techniques, the use of novel antiepileptic drugs, and non-pharmacological treatment options for intractable epilepsy will be discussed.