In recent years， a large number of epilepsy pathogenic genes have been gradually revealed with the advancement of genetic testing technology. Studies on the clinical phenotypes and pathophysiologic mechanisms associated with epilepsy pathogenic genes have made precision epilepsy treatment possible. In actual clinical practice， early identification of epilepsy pathogenic genes is crucial for effective treatment and the selection of appropriate antiepileptic drugs. This article provides an overview of a variety of currently known epilepsy pathogenic genes that have guided clinical therapy， with a view to helping clinicians select appropriate epilepsy treatment programs.