Epilepsy is a common neurological condition with a significant socioeconomic impact. Approximately one in three patients is resistant to the available therapies, and the mechanisms of this resistance are often unclear. Neuroinflammation, recognised as a potential cause of drug-resistant epilepsy, plays a key role in modulating synaptic transmission and hyperexcitability. In this narrative review, we explore the molecular basis of neuroinflammation in epilepsy and its potential as a source of biomarkers for diagnosis and treatment. Evidence from human and animal studies indicates a strong association between neuroinflammation and epilepsy, with significant involvement of pro-inflammatory molecules and blood-brain barrier dysfunction. We highlight the roles of microglia, astrocytes and inflammatory molecules in epilepsy, suggesting that targeted anti-inflammatory therapies could be promising for treatment. Further research is needed to fully understand the role of neuroinflammation in epilepsy and to develop new therapeutic approaches.