Epilepsy is a chronic brain disease characterized by central nervous system dysfunction, and its frequent seizures have a serious impact on the quality of life for patients. At present, the primary treatment is based on Western anti-epileptic medications; however, long-term use of these drugs can lead to a series of adverse reactions. Chaihu Jia Longgu Muli Decoction, mentioned in Article 107 of the On Cold Damage (Shang Han Lun), has been commonly used by both ancient and modern physicians to treat mental and emotional diseases such as "chest fullness and agitation". In recent years, many studies have shown that this formula has a significant efficacy in treating epilepsy. Chaihu Jia Longgu Muli Decoction can exert its anti-epileptic effects by regulating neurotransmitters, enhancing the function of central nervous systems cells, and modulating inflammatory markers. This formula serves multiple functions, including harmonizing the Shaoyang, Tongyang Xiezhuo, and tranquilizing mind. Its effects are multi-targeted and systemic in nature. In the clinical treatment of patients with epilepsy, Chaihu Jia Longgu Muli Decoction has played an important role. This article offers a comprehensive overview of the recent developments regarding this formula's application in epilepsy treatment, focusing on the prescription compatibility, its underlying mechanisms of action, and relevant clinical observations.