Epileptic and non-epileptic seizures are a common neurologic symptomatology in pediatrics with a frequency 4%-10% in pediatric population. Epileptic seizures are most common in infants and small children, presenting as epileptic spasms and febrile seizures. Therefore, diagnostic procedures and treatment of pediatric patients with the new-onset (fi rst) seizures, as well as the management and harmonization of organization and function of neuropediatric services at diff erent levels of care require constant eff orts for improvement. We analyzed diagnostic and therapeutic practice parameters of epileptic seizures by searching the Medline database (PubMed) according to diff erent age groups, clinical circumstances and seizure duration. Study results revealed the management of recent-onset (fi rst) epileptic seizure to be performed at the primary care level after obtaining medical history, clinical examination and seizure treatment. These patients should be referred to tertiary care level for diagnostic procedures and further treatment approach. Lumbar puncture should be performed in infants with simple febrile seizures if not vaccinated previously according to the schedule or if the patient has been treated with antibiotics or if signs of the central nervous system (CNS) infection are present. Electroencephalography (EEG) and neuroimaging are not indicated in patients with simple febrile seizures, either for diagnostic purpose or during follow up. Laboratory investigations are indicated for febrile state evaluation and analysis of blood glucose and electrolytes, especially in infants. EEG is recommended in all patients with the fi rst non-febrile epileptic seizure and should also be considered in patients with complex febrile seizures. Lumbar puncture is recommended in all patients with non-febrile seizures if clinical signs of CNS infection are present and is mandatory in neonates and infants. In patients with status epilepticus and recurrent seizures, metabolic and genetic testing should be considered. Neuroimaging is recommended in each patient after fi rst non-febrile epileptic seizure. Magnetic resonance imaging of the brain is the method of choice in pediatric patients for diagnosis of epileptic seizure etiology, follow up and prognosis. Computed tomography of the brain is the method of choice for emergency care interventions. If the seizure lasts for 5 minutes or longer (epileptic status), treatment with diazepam (0.2 mg/kg i.v.) should be administered, and in neonates phenobarbitone 10-20 mg/kg i.v. In case of prehospital/outhospital settings, rectal diazepam or i.m. midazolam (0.2 mg/kg) should be applied. In case of refractory status, therapy with midazolam in infusion or anesthetics and B6 100 mg i.v. is recommended in neonates. In conclusion, there is a lack of evidence-based diagnostic and therapeutic recommendations for nonfebrile epileptic seizures in pediatric patients in the literature. Further clinical trials are necessary