Transcranial magnetic stimulation (TMS), as a non-invasive neurophysiological technique to measure cerebral cortical excitability, has been widely used to study the etiology and drug resistance mechanism of epilepsy in recent years. This article reviews the application of single/paired pulse TMS in detection of cortical excitability in patients with epilepsy, and summarizes the role of TMS in exploration of causes, classification and medication guidance of epilepsy.