Pediatric Epilepsy still poses a management challenge in terms of acute seizure management despite the availability of a variety of anticonvulsants.Children with intractable epilepsy requires frequent inpatient admissions and emergency room visits due to status epilepticus or acute repetitive seizures.Acute seizure management reduces the development of permanent neurological sequelae in children.Benzodiazepines still remain the old conventional first line treatment as demonstrated in randomized clinical trials.Approval of fosphenytoin, valproate and rectal diazepam more than a decade ago gave physician more choices in managing this medical emergency.The use of Intranasal and buccal midazolam, and rectal diazepam on an outpatient basis to abort seizure activity in acute repetitive seizures made a huge impact in terms of reduction of frequent hospital visits.Intravenous Levetiracetam approval in the last few years has provided another option to the physicians in children who failed the other approved anticonvulsants.Recent studies have shown that intravenous Levetiracetam has been used to treat both status epilepticus and acute exacerbation of seizures in children and neonates.This is based on case series and retrospective studies.Larger prospective multicenter trials are required to prove the efficacy of this newer agent in this patient population.