The precuneus is located on the posteromedial side of the parietal lobe and has extensive cortical and subcortical connections. Functional imaging studies have shown that the precuneus has four subregions with different functional connectivity patterns: the anterior sensorimotor area, the central cognitive area, the posterior visual area, and the ventral limbic area. The precuneus plays a core role in a series of highly integrated tasks, including visual-spatial processing, sensorimotor functions, episodic memory, self-processing, and consciousness. Its importance in complex cognitive functions is related to the three brain networks it participates in: the default mode network (DMN) core, the DMN episodic memory subnetwork, and the para-cingulate network. Vestibular reactions, visual symptoms, and body image disturbances are the main non-motor symptoms of precuneus epilepsy, while postural tonic and hypermotor are the main motor symptoms of its seizures. The differences in clinical features may be related to the specific location of the epileptogenic zone in the precuneus and the diffusion pattern of epileptic seizures. Precuneus epilepsy is mostly drug-resistant epilepsy, and the value of scalp EEG localization is limited, so surgical treatment is an effective option.