Most studies evaluating VNS were conducted in a subgroup of patients with refractory epilepsy who continued having daily seizures and who were not eligible for surgery. The identified studies describe that vagus nerve stimulation is a complementary treatment with few severe side effects in this type of patients. In general, it is considered as a palliative procedure since, in the studied subgroup and depending on the type of epilepsy, 30-50% achieves 50% or higher reduction in the frequency of seizures. Although VNS may lessen the number of seizures in some patients, so far, there is no evidence to indicate that this would reflect a reduction in associated morbidity and mortality or significant quality of life improvement. Ultimately, for those patients with refractory epilepsy who have daily seizures and who are not eligible for surgery, the decision of using vagus nerve stimulation may be a therapeutic alternative.