Social cognition is a core ability that enables individuals to recognize others' emotions and intentions and relies on a highly coordinated social brain network (SBN), which includes key brain regions such as the fusiform gyrus, amygdala, and medial prefrontal cortex. As a network disorder, epilepsy not only causes seizure manifestations but also disrupts the structure and function of the SBN through direct involvement of epileptogenic foci or the remote propagation of abnormal discharges, leading to social cognitive impairments such as difficulties in emotion recognition, deficits in theory of mind, impaired empathy, and abnormalities in social decision-making. Children and adolescents with epilepsy are particularly vulnerable to deviations in social cognitive development because their brain networks are still undergoing maturation. This review systematically elaborates on the neural underpinnings and clinical manifestations of the SBN in epilepsy, as well as its developmental characteristics in children and adolescents, and proposes a clinically translatable pathway from assessment to intervention. Furthermore, it emphasizes the integration of neuroimaging, neuropsychological assessment, and multimodal rehabilitation strategies to promote a paradigm shift in epilepsy management from seizure control to the improvement of social functioning.