Surgery is a successful method of treatment for certain epilepsies. Patient evaluation is directed towards seizure classification and localization. In most cases patients are able to progress from a noninvasive evaluation utilizing extracranial electrodes directly to resective surgery. In a few complex situations patient evaluation requires the placement of intracranial electrodes for accurate localization of the epileptogenic focus. The placement of intracranial electrodes is a surgical procedure which carries significant risk. Meticulous multidisciplinary care is required to achieve a safe and successful surgical outcome. Astute nursing care is pivotal to the success of intracranial monitoring and essential to the prevention of complications.