In this article, we have tried to review the evidence regarding the use of second line agents in status epilepticus, comparing phenytoin and valproate in particular. While phenytoin continues to be used as the preferred second line agent, valproate is equally effective and safe. However, there is need for generating more evidence particularly with respect to safety profile of these two drugs in comparison to each other so that, a consensus may be arrived at in future as to, which is the best second line drug among these two agents in terms of both safety and efficacy.

Keywords: Phenytoin, Valproate; Status epilepticus; Second line agents; Diazepam; Midazolam.