Backgroud Because the underlying molecular mechanism remains poorly understood, there is no effective treatment for refractory status epileptieus (RSE). Thus overall mortality for RSE has been reported up to 50%. However, several studies have demonstrated that ketamine could be an effective drug for stopping RSE.　Objective　To summarize the underlying molecular mechanism of RSE and explore researches of ketamine used in RSE, aiming at providing practical advice for clinical application.　Content　The molecular mechanism of RSE was attributed to abnormal γ-aminobutyric acid(GABA) receptor or excessive releasing of Glu and so on. Ketamine combined with other antiepileptic drugs could stop RSE safely and effectively.　Trend　Early application of ketamine combined with other antiepileptic drugs could prove prognosis of RSE and its application prospect should be further studied.