Purpose of review: Caffeine is the most widely consumed central nervous stimulant. For people with epilepsy, it is often unclear whether drinking coffee carries a risk of triggering seizures. Recent findings: The relationship between caffeine, seizures, epilepsy and anti-seizure drugs is not fully understood. Clinical studies are scarce. In animal models, caffeine can increase seizure susceptibility but can also protect from seizures. Effects seem dose-dependent and, influenced but the duration of intake and the developmental stage at which caffeine exposure started. Caffeine lowers the efficacy of several anti-seizure medication, especially topiramate. Summary: It is unclear how these findings, mainly from animal studies can be translated to the clinical condition. At present, there is no evidence to advice people with epilepsy against the use or overuse of caffeine. Until clinical studies suggest otherwise, caffeine intake should be considered as a factor in achieving and maintaining seizure control in epilepsy.