Anterior cingulate epilepsy is a diagnostic and therapeutic challenge, with a broad range of nonspecific symptoms. Seizures can arise from any region of the anterior cingulate cortex (ACC) and manifest distinctive features based on the area of onset and pattern of spread. These features may provide insight as to the origin of the seizures, but because the ACC integrates information from several networks involving emotional and executive functions and has a diverse cytoarchitecture, functional-structural correlates are complex. Further, the location of the ACC within the interhemispheric fissure limits the capacity of scalp electrodes to record seizure activity from this region. This case review illustrates one part of the spectrum of cingulate epilepsy and discusses clinical features of the disorder.