Accurately diagnosing pediatric patients with specific epilepsy syndromes remains a major challenge today. The diagnosis of epilepsy syndrome is established on the basis of the age of onset, type of epilepsy, progressive nature of the disease, interictal EEG abnormalities, gender predominance, precipitating factors, family history, neuropsychological features and prognosis. A diagnosis of pediatric epilepsy syndrome can be complicated by a number of factors and the established diagnosis affects the treatment options. Further, pediatric epilepsy patients respond differently to various treatments making prognosis difficult. Epilepsy syndromes are further divided into generalized, focal, undetermined and “special” syndromes based on the Committee on Classification and Terminology of the International League Against Epilepsy (1989). In this chapter, we will discuss the major epileptic syndromes seen in childhood and adolescence, their salient clinical features, ictal and interictal EEG characteristics, prognosis and treatment options.