Objective To explore the diagnostic value of Video electroencephalogram (Video-EEG) monitoring in children epilepsy. Methods Video-EEG monitoring under the state of awaking and sleeping were performed 4-8 hr in 102 epilepsy children. We analysed the relation between clinical seizures and abnormal discharge, observed the phase when abnaomal discharge appeared. Results abnormal discharge were captured in 76 patients (76/102,74.51%), and among the 76 patients, 23 patients had clinical seizures accompanied synchronous abnormal discharge, 53 patients just had interictal epileptiform discharge only, all of them were diagnosed epilepsy according to Video-EEG and case history.Among of them, 52 were focal (52/76,68.42%), and 55 were found in sleeping (55/76,72.37%). 10 patients (10/102,9.80%)were just clinical seizures unaccompanied synchronous abnormal discharge, and these cases were defined nonepileptic seizures. Conclusions Video-EEG can improve epilepsy diagnostic rate, is favourable to localization of epilepsy. Partly sleep deprivation is an effective method to increase detection of epileptiform discharge.