One to two percent of visits to the emergency department are due to seizures. These patients may require aggressive stabilization and resuscitation and concurrent implementation of diagnostic testing, monitoring, and pharmacologic interventions. Seizures are usually a manifestation of an underlying pathology which requires thorough evaluation, including a careful history, physical examination, laboratory work-up, and electroencephalographic and neuroimaging studies as dictated by clinical suspicion. The evaluation and treatment of seizures in the emergency department must be comprehensive, including giving consideration to the patient's medical and social resources.