The cardio-respiratory aspects of seizures have been proposed as explanatory mechanisms for sudden unexpected death in epilepsy (SUDEP). Theories were proposed which considered seizures as a terminal event for SUDEP. Ictal asystole, ictal bradyarrhythmia and tachyarrhythmia are possible explanations which have been reported, although the relative occurrence of these phenomena remains low. Other observations from case reports and case series pointed towards apnoea and ictal hypoxaemia as a putative terminal event for SUDEP. Many theories also considered the modifi cation of the cardiorespiratory system by the underlying chronic epilepsy and anti-epileptic agents. Preventive measures for SUDEP have yet to be established despite the growing understanding of the cardio-respiratory mechanisms of SUDEP.