Abstract: Anti-epileptic drugs (AED) are the mainstay of current treatment to control epileptic seizures. Studying the risk factors of seizure recurrence after drug withdrawal plays an important role in formulating scientific drug reduction and discontinuation plans and improving the quality of life of patients with epilepsy. Based on extensive literature search, this review summarizes and discusses some questions mainly related to epidemiological characteristics, the potential risk factors, and the prediction of recurrence of epilepsy after drug withdrawal, the strategy of AED reduction/withdrawal in special populations, and practical intervention after drug withdrawal, aiming to provide targeted and practical reference for the clinical decision-making of AED drug withdrawal.