Medical emergencies such as “Super-Refractory Status Epilepticus (SRSE)” and “Refractory Status Epilepticus (RSE)” have significant rates of morbidity and fatality. While SRSE is defined as SE that continues or recurs despite at least 24 hours of anesthesia with continuous electroencephalography monitoring, RSE is defined as SE that persists or recurs despite sufficient therapy with first- and second-line antiepileptic medications. RSE and SRSE have a complicated and multifaceted etiology that involves a series of excitatory and inhibitory pathways that result in chronic seizure activity. Similar to convulsive SE in terms of clinical characteristics, RSE and SRSE may also entail non-convulsive SE or mild clinical seizures that are challenging to identify. RSE and SRSE diagnosis necessitates quick identification and adequate treatment, which includes managing critical care and taking into account cutting-edge therapeutic options including immunomodulatory medication, the ketogenic diet, or epilepsy surgery. Patients with RSE and SRSE have a terrible prognosis, and survivors have been found to have long-term cognitive and functional problems. To enhance patient outcomes, it is vital that we understand the pathogenesis, diagnosis, and treatment of RSE and SRSE better.