Recording neural activity has been a critical aspect in the diagnosis and treatment of patients with epilepsy. For those with intractable epilepsy, intracranial neural monitoring has been of substantial importance. Clinically, however, methods for recording neural information have remained essentially unchanged for decades. Over the last decade or so, rapid advances in electrode technology have begun to change this landscape. New systems allow for the observation of neural activity with high spatial resolution and, in some cases, at the level of the activity of individual neurons. These new tools have contributed greatly to our understanding of brain function and dysfunction. Here, the authors review the primary technologies currently in use in humans. The authors discuss other possible systems, some of the challenges which come along with these devices, and how they will become incorporated into the clinical workflow. Ultimately, the expectation is that these new, high-density, high-spatial-resolution recording systems will become a valuable part of the clinical arsenal used in the diagnosis and surgical management of epilepsy.