Currently, approximately one-third of epilepsy patients exhibit resistance to anti-seizure medications (Anti-seizure medications, ASMs), which can only alleviate symptoms, but cannot completely cure the condition. Consequently, the development of new ASMs from an understanding of epilepsy pathogenesis has emerged as an urgent social issue. The role of neuroinflammation in various neurological diseases has garnered significant attention as a popular research topic both domestically and internationally. Numerous studies have corroborated the involvement of neuroinflammation in the onset and progression of epilepsy. The biological target, Translocator protein 18 kDa (TSPO), is considered as a marker of neuroinflammation and is intricately involved in the entire neuroinflammatory response. Investigating the function of TSPO in epilepsy neuroinflammation can potentially uncover new treatment targets. At present, the exact mechanism of TSPO in epilepsy neuroinflammation remains unclear, thus necessitating a comprehensive summary and overview. This article reviewed the advancements made in TSPO research within the realm of neuroinflammation and its role in epileptic neuroinflammation, aiming to contribute novel insights for the identification of related targets and pathways for epilepsy treatment.