ObjectiveTo observe the epilepsy relapse of prepubertal children with epilepsy onset after drug reduction and withdrawal, and to evaluate the risk factors associated with relapse.MethodsA collection of 61 children, aged 1 month to 10 years old with seizure-free epilepsy for morn than 3 years after treatment with regular anti-epileptic drugs in our hospital from March 2008 to March 2018, were divided into the recurrent group and non-recurrent group according to relapse or not after the drug reduction and withdrawal.Fisher’s exact test/Chi-square test was used to analyze and evaluate the risk factors related to epilepsy recurrence.ResultsThe differences in epileptiform discharge as detected by video electroencephalogram(VEEG)in the patients of the recurrent group and non-recurrent group before and during drug reduction and within 0.5 years of drug withdrawal, unauthorized drug reduction or drug withdrawal were statistically significant(P=0.049, 0.020, 0.024), which are the risk factors for recurrence of epilepsy.However, there was no significant difference between two groups in family history, cranial MRI, VEEG within 0.5 to 1 year of drug discontinuation, gender and age, etc(P>0.05).ConclusionThe relapse of epilepsy in prepubertal children during drug reduction or after drug withdrawal was associated with many factors.VEEG before drug reduction, during drug reduction, and within 0.5 years of drug withdrawal has important value in predicting epilepsy recurrence.Gradually reducing the drug according to the doctor’s advice, and avoiding unauthorized sudden and rapid drug reduction or withdrawal can reduce the possibility of the epilepsy relapse.