During the first decade of the 21st century, epilepsy related genes were discovered. These genetic discoveries opened the field of epilepsy genetics and advanced our understanding of the cellular mechanisms involved in epilepsy. Over the subsequent ten years, the availability of clinical genetic testing along with rapidly growing knowledge of epilepsy genetics transformed patient care. This has dramatically changed how childhood onset epilepsy is treated. This new genomic era offers a great opportunity for the advancement of health outcomes and epilepsy research. It has also created new demands and challenges for physicians, requiring specialized expertise in epilepsy genetics in order to provide best care for patients and their families.