For the one-third of patients with epilepsy whose seizures are refractory to medications and who are not surgical or dietary therapy candidates, alternative therapies such as neurostimulation provide a promising alternative. Neurostimulation techniques include vagus nerve stimulation, deep brain stimulation (particularly stimulation of the anterior thalamus), and responsive neurostimulation. Accumulating data support neurostimulation techniques as a safe and effective option for seizure reduction and improved quality of life for drug-refractory patients.