Until recently, antiepileptic drugs and traditional epilepsy surgery were the two primary treatment options available to patients with epilepsy. Drug therapy, however, does not always control seizures and can be associated with negative side effects. Additionally, only a minority of patients are candidates for epilepsy surgery. Vagus nerve stimulation (VNS) therapy, approved by the US FDA in 1997, is now a treatment option that is effective in reducing seizure frequency and severity as well as improving patient quality of life without the pharmacological side effects associated with traditional antiepileptic drugs. Provided here is an overview of VNS therapy and the VNS therapy system, including the history of vagal nerve stimulation, patient selection guidelines and new indications currently under investigation for this novel therapy.