Abstract Epilepsy is a diverse disease consisting of several different types and subgroups. The pathophysiology can also differ between the different types, and in many cases, the pathophysiology is not fully known. There are several factors influencing the clinical picture of the patients, amongst others, seizure precipitating factors. This review focuses on precipitating factors for epileptic seizures, and alcohol specifically. The knowledge about alcohol as a precipitating factor on epileptic seizures is not extensive. It is therefore necessary to address the pathophysiology behind epilepsy, how alcohol will interact with the CNS, and finally if and how alcohol will precipitate epileptic seizures. There is not enough material in the literature to draw definite conclusions, but one can see tendencies on basis of the information we have. Alcohol will interact with the physiology of the CNS and may cause seizures. In the end of this review, there is also a small clinical trial of 20 patients in the Neurologic Outpatients Clinic at Oslo University Hospital Rikshospitalet. They underwent a questionnaire and answered questions about their disease and seizures and whether they experienced alcohol as a precipitating factor. The conclusion is that this is an important subject since alcohol is widely used in the population, and is a potentially easy factor to avoid. There is however the need for further research and documentation on the subject.