In this review, the authors perform a database search and summarize and discuss all eligible studies that provide (subgroup) analysis of the postoperative seizure outcome of patients with cavernoma-related epilepsy undergoing sole lesionectomy or lesionectomy including the hemosiderin rim. Based on the currently available data, the authors conclude that if surgical treatment of cavernoma-related epilepsy is performed, the peri-lesional hemosiderin should be resected. However, cases of eloquent or multiple localization or widespread hemosiderin deposit in which a complete resection is challenging should undergo a specific preoperative work-up.