Status epilepticus is a life-threatening emergency. However, there are different forms of status epilepticus: focal to bilateral tonic-clonic status epilepticus and focal status epilepticus. Focal status epilepticus may have prominent motor symptoms, often with impaired awareness, or may be nonconvulsive. The implications of this are important: the treatment of focal to bilateral tonic-clonic seizures requires immediate action. Evidence for first-line therapy is clear that benzodiazepines should be administered in adequate doses we will review those studies. New evidence for second-line treatment has emerged, as well. In those with focal status epilepticus, urgent treatment is still indicated but the approach is more nuanced and less likely to require an escalation to third-line agents, such as anesthetics. We review these concepts and provide some guidance for clinical practice.