Abstract Epilepsy, a neurological disorder characterized by recurrent seizures, affects millions of people worldwide. Significant advancements in both diagnostic and therapeutic approaches have greatly improved outcomes, particularly for individuals with drug-resistant epilepsy. Modern neurostimulation techniques such as Responsive Neurostimulation (RNS), Deep Brain Stimulation (DBS), and Vagus Nerve Stimulation (VNS) have demonstrated effectiveness in reducing seizure frequency in these patients. Additionally, emerging technologies like gene therapy and optogenetics are being explored to better understand the underlying mechanisms of epilepsy and hold promise as future treatment modalities.Traditional imaging techniques often fail to detect subtle epileptogenic zones. However, the introduction of ultra high-field 7T MRI scanners represents a major breakthrough. These advanced scanners use eight transmitters to generate higher-resolution images, reducing signal dropout and enabling the identification of previously undetected lesions. In one study involving 31 patients, 58% had their treatment plans modified based on 7T MRI findings, highlighting its potential to inform surgical decision-making. In terms of pharmacological treatment, newer medications such as sultiame, cannabidiol (CBD), and non-pharmacological approaches like the ketogenic diet have emerged as additional therapeutic options for drug-resistant epilepsy. These developments contribute to more effective, personalized management strategies for epilepsy. In summary, the landscape of epilepsy diagnosis and treatment is rapidly evolving. Innovations in imaging and therapeutic interventions are offering new hope for patients with drug-resistant epilepsy. Ongoing research and clinical trials remain essential to further refine these approaches and improve patient outcomes.