Neuropsychological assessments before and after epilepsy surgery are an established practice. In contrast, the comprehensive assessment of psychological factors has so far been neglected. It is well understood, however, that these factors impact the adjustment to, recovery from, and perception of success or failure of epilepsy surgery. Given the complex relationship between epilepsy surgery outcome and psychological factors, regular and long-term monitoring is essential, both before and after surgery. Quality of life, depression, anxiety, and seizure frequency and severity should be evaluated at a minimum to monitor adjustment to life before and after epilepsy surgery. Questionnaires developed specifically for people with epilepsy are preferred. Structured interviews are particularly effective for assessing depressive and anxiety disorders, ensuring accurate diagnosis and timely referral to psychological services. Much is still to be learned about which personal factors exactly play a role, how they interact with each other, and how this affects perceived surgical intervention outcomes. Well-informed psychological assessment procedures will shed light on this, and they should become an integral part of the surgical care continuum to maximize mental health outcomes and overall quality of life in people with epilepsy.