This article briefly described the theoretical origin of the treatment of post-stroke epilepsy (PSE) from the perspective of phlegm, and discussed the treatment principles of PSE. Through literature review, it was found that treating PSE with phlegm therapy could significantly improve various clinical indicators of patients, with good clinical efficacy and fewer adverse reactions. Some formulas with expectorant effects were used to treat PSE, such as Ditan Tang, Dingxian Wan, Huatan Tongluo Tang, and Antiepileptic Decoction. The treatment of PSE based on phlegm might be a research direction in the future.