Over 2 million people are treated medically each year in the United States after sustaining a traumatic brain injury (TBI) (1), and posttraumatic epilepsy (PTE), which is often intractable to medical treatment, is a common long-term consequence of TBI. Epilepsy affects 1% to 2% of the population (2), but the overall incidence of epilepsy after moderate-to-severe closedhead injury is 7% to 39% and is over 50% after penetrating injury (3)(4)(5). Approximately 20% of all symptomatic epilepsies result from TBI (6), making PTE one of the most prevalent types of epilepsy. Although a number of seizure types can develop after brain trauma, PTE manifests as temporal lobe epilepsy (TLE, either neocortical or mesial) in 35 to 62% of trauma patients (7-9). As with other forms of acquired epilepsy, spontaneous recurrent seizures associated with PTE develop with a latency ranging from weeks to many years after the initial injury. This seizure-free period after TBI is thought to represent the period of epileptogenesis, during which the brain undergoes physiological, anatomic, cellular, and molecular changes that lead to a state of chronically increased seizure susceptibility. In principle, this delay between the TBI and development of PTE also represents a window of opportunity during which strategies might be employed to inhibit the reactive plasticity in the brain that leads to PTE, but no antiepileptogenic therapies have been successfully developed to date. This review focuses on key pathophysiological changes in the brain associated with posttraumatic epileptogenesis, animal models used to study those changes, and efforts to identify predictive biomarkers of PTE and to employ candidate treatments to prevent PTE.TBI results in acute cell death, axon injury, vascular damage, and accompanying excitotoxicity shortly after injury. Secondary damage, occurring within days of the primary injury, including or resulting from hypoxia/ischemia, delayed necrotic and apoptotic cell death, oxidative stress, gliosis, edema, blood brain barrier disruption, and inflammation may exacerbate initial damage. Putative homeostatic repair mechanisms, including angiogenesis, synaptic reorganization, and neurogenesis can engage over time and are hypothesized to compensate for functional loss resulting from the initial injury; they are also associated with PTE. By their very nature, brain injuries are highly variable across patients, and this heterogeneity is reflected in a wide variety of epileptogenic responses to injury. Injury severity and location, the presence of seizures shortly after injury, intracranial hemorrhage, cortical contusion, the level of postinjury consciousness impairment, age, and sex have all been implicated as potential factors associated with increased risk of developing PTE after brain trauma (4, 5, 10). Many of the cellular events that occur after TBI also occur after insults used to induce epilepsy in animal models, and rodent models of PTE have been developed with the goal of identifying those factors associated with the e...