Emilio Russo, MD, PhD, Università Magna Graecia di Catanzaro, Catanzaro, Italy, discusses the connection between the gut and the brain in the context of epilepsy. In the last 20 years, we have started to understand a bit more about the gut-brain axis. Research is still attempting to understand how it would have an impact on our health, and there has been some proof of concept now in some disorders such as multiple sclerosis and Parkinson’s disease. However, much is still not understood about the connection between the gut and the brain. Recent research has worked on manipulating the gut microbiome to see how it affects the cells, however, it is not simple as there are many factors to be considered. The connection between the gut and brain is also bidirectional, so inflammation in the gut can lead to inflammation in the brain. There are many players involved in the gut-brain axis, so it has been challenging to understand the mechanisms completely. Manipulating the microbiota has also been shown to impact seizure outcomes in epileptic patients as well. Dr. Russo is optimistic for the future as further research into this topic may lead to new pharmacological treatments or targets to be used in clinical practice.This interview took place during the 34th International Epilepsy Congress, 2021.