The field of epilepsy is advancing with significant innovations in both diagnostic and therapeutic areas. The seventeenth Epilepsy Therapies and Diagnostics Development conference, held in May-June 2023, highlighted recent and ongoing developments. Therapeutics are targeting various mechanisms, including genetics, ion channels, neurotransmitters, and other novel approaches such as stem cells and gut microbiome interventions. Devices for seizure monitoring and treatment, such as vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS), continue to show promise, with ongoing trials evaluating their efficacy and safety. Electronic seizure diaries and detection devices are also improving patient reporting and seizure documentation. Despite these advancements, challenges remain in developing broadly effective and well-tolerated treatments, particularly for rare epilepsies. The conference emphasized the need for continued innovation to improve the lives of people with epilepsy.The field of epilepsy is advancing with significant innovations in both diagnostic and therapeutic areas. The seventeenth Epilepsy Therapies and Diagnostics Development conference, held in May-June 2023, highlighted recent and ongoing developments. Therapeutics are targeting various mechanisms, including genetics, ion channels, neurotransmitters, and other novel approaches such as stem cells and gut microbiome interventions. Devices for seizure monitoring and treatment, such as vagus nerve stimulation (VNS), responsive neurostimulation (RNS), and deep brain stimulation (DBS), continue to show promise, with ongoing trials evaluating their efficacy and safety. Electronic seizure diaries and detection devices are also improving patient reporting and seizure documentation. Despite these advancements, challenges remain in developing broadly effective and well-tolerated treatments, particularly for rare epilepsies. The conference emphasized the need for continued innovation to improve the lives of people with epilepsy.