Background: Epilepsy surgery represents a valuable treatment for people with drug-resistant epilepsy, which often leads to a substantial improvement in the cognitive-behavioral domains and to a better quality of life, especially in children. A neuropsychological assessment is considered mandatory and should form an integral component of the presurgical evaluation and assessment of postoperative outcome for all epilepsy surgery patients. In this context, the presurgical neuropsychological assessment in combination, as well as other relevant neurological investigations are important for assessing the risk of potential postsurgical cognitive deficits, to determine the dominant hemisphere responsible for language function and to predict the risk of memory decline and of visual and motor deficits. A postsurgical neuropsychological assessment is necessary in assessing the outcomes because cognitive decline is one of the most significant sequelae of epilepsy surgery. Conclusions: The neuropsychological assessment remains an obligatory and valuable part of the presurgical and postsurgical assessment. This article provides a comprehensive overview of the role of neuropsychological assessment in the pre- and postsurgical evaluation of epilepsy surgery patients. The neuropsychological profile may have a predictive role for the identification of the cognitive risk, prognosis, and treatment. New researches about neuropsychological assessment may provide many relevant answers about the outcome of the epilepsy surgery as well as to influence the quality of life.