Stroke is the most common cause of newly diagnosed epilepsy in the elderly, ahead of degenerative disorders, brain tumors, and head trauma. Stroke accounts for 30–50% of unprovoked seizures in patients aged ≥ 60 years. This review discusses the current understanding of epidemiology, risk factors, mechanisms, prevention, and treatment opportunities for post-stroke epilepsy (PSE). We performed a literature search in the PubMed and Cochrane Library databases. The keywords "stroke, epilepsy", "stroke, seizure", "post-stroke seizure", "post-stroke epilepsy" were used to identify the clinical and experimental articles on PSE. All resulting titles and abstracts were evaluated, and any relevant article was considered. The reference lists of all selected papers and reference lists of selected review papers were manually analyzed to find other potentially eligible articles. PSE occurs in about 6% of stroke patients within several years after the event. The main risk factors are cortical lesion, initial stroke severity, young age and seizures in acute stroke period (early seizures, ES). Other risk factors, such as a cardioembolic mechanism or circulation territory involvement, remain debated. The role of ES as a risk factor of PSE could be underestimated especially in young age. Mechanism of epileptogenesis may involve gliosis scarring, alteration in synaptic plasticity, etc.; and ES may enhance these processes. Statins especially in the acute period of stroke are possible agents for PSE prevention presumably due to their anticonvulsant and neuroprotection effects. Antiepileptic drugs (AED) monotherapy is enough for seizure prevention in most cases of PSE; but no evidence was found for its efficiency against epileptic foci formation. The growing interest in PSE has led to a notable increase in the number of published articles each year. To aid in navigating this expanding body of literature, several tables are included in the manuscript. Further studies are needed for better understanding of the pathophysiology of PSE and searching the prevention strategies. • Cumulative risk for PSE is 12-15% after hemorrhagic and 7-9% after ischemic stroke, and increases to 11-16% in middle age. • Hemorrhage, severe stroke, cortical lesion, early seizures occurrence and young age are the most crucial PSE predictors. • Hemosiderin deposition, slow neurological recovery, acute epileptiform abnormalities remain as possible predictors for PSE. • Stroke creates conditions for destabilization of cell membranes, increased excitatory and decreased inhibitory inputs. • Statins might have the capability to attenuate processes contributing to maladaptive plasticity in the penumbra area. [ABSTRACT FROM AUTHOR]