With the progress of genetic testing technology, a large proportion of genes associated with epilepsy are revealed. And these genes are often linked to drug-resistant epilepsy (DRE), for which surgical treatment can be an important intervention. This article reviews the progress of surgical treatment for gene-related epilepsy and focuses on influence factors of surgical outcomes, including timing of surgery, extent of lesion resection, and preoperative assessment methods. Through early surgical intervention, some patients with specific gene mutations (eg. TSC), can significantly improve neural development and control epilepsy greatly while some patients with other gene mutations (eg. SCN1A) have less favorable outcomes. Individualized preoperative assessment, accurate localization of the epileptogenic zone, and complete resection of the lesion are key to good prognosis. Although current studies are mostly based on small sample sizes, the existing evidence provides a theoretical foundation for the advancement of epilepsy surgery toward more precise approaches.