Neurocysticercosis is the most common cause of late-onset epilepsy in developing countries. The larval stage of Taenia solium is the causative agent of the disease. Recent advances in neuroimaging and serologic diagnostic techniques have led to increased recognition of its importance, but its pathogenesis is just beginning to be clarified. Experts now agree that the clinical manifestations, pathogenic mechanisms and optimal treatment vary with the number of parasites, their location and the degree of host inflammation. Symptomatic therapy (i.e., antiepileptic medications and, when indicated, surgery) is critically important but there are also important roles for antiparasitic and anti-inflammatory drugs. Neurocysticercosis is a potentially eradicable disease but this is probably unlikely to be achieved in the short term.