A study conducted by Juan Luis Alcala-Zermeno, MD, and colleagues explored racial disparities within epilepsy care, specifically focusing on the utilization of invasive neuromodulation devices in patients with focal drug-resistant epilepsy (DRE). The researchers conducted a post hoc analysis of data from the Human Epilepsy Project 2, a multicenter study across the United States, to investigate utilization patterns according to race and ethnicity. Despite a study population that mirrored the racial distribution of the US population, except for multiracial individuals, findings revealed a notable discrepancy in device utilization. Among 154 patients with focal DRE, 55 (36%) underwent invasive neuromodulation, and 36 (71%) of those patients were White. Patients identifying solely as Black/African American were substantially less likely to receive these devices compared to their counterparts, uncovering a significant disparity (OR, 0.21, 95% CI, 0.05-0.96, P=0.03). This suggests that invasive neuromodulation for managing DRE is markedly underutilized within the Black/African American population. Dr. Alcala-Zermeno and colleagues called for further research to validate the findings and new strategies to close gaps in epilepsy treatment.