Epilepsy is a clinical diagnosis based on the history of the patient and of witnesses. Sometimes this is not available or is incomplete, thus making diagnosis uncertain. In other cases, specifically in patients with intractable epilepsy being considered for epilepsy surgery, the diagnosis of epilepsy is not in doubt but the precise localisation of the epileptogenic zone needs to be determined. In both these situations, video telemetry plays a key role and is now a routine in most neuroscience units. This review covers existing practice and the exciting recent development of home video telemetry.