Epilepsy is a neurological disorder characterized by a predisposition for the occurrence of abnormal excessive and synchronous neuronal discharges that lead to epileptic seizures, which can be a significant burden for the patient, and can be potentially life endangering. Epilepsy is a common disease with an incidence of 50 cases per 100,000 people per year in developed countries and a prevalence of 4 to 10 cases per 1000 people per year. Drugs used in anesthesia often have an effect, whether positive or negative, on epilepsy and epileptic seizures. It is important that the anesthesiological approach to a surgical patient with epilepsy is adapted to his condition in order to avoid undesirable events such as epileptic seizures or status epilepticus, whether during or immediately after surgery. With the surgical treatment of epilepsy, there is a wide selection of surgical and anesthesiological techniques that need to be carefully chosen for each individual patient and his needs. In patients with epilepsy in whom noninvasive EEG and neuroradiological imaging methods like MRI and CT are not sufficient for the localization of epileptogenic lesions, or in those in whom the lesion is located near key areas of the brain, awake craniotomy can be used along with invasive electrocorticography or cortical mapping during which it is critical to adapt the effects of anesthesia on neurophysiological functions so that epileptiform activity would not be suppressed which would make the procedure impossible.