The International League Against Epilepsy and the International Federation of Clinical Neurophysiology developed a clinical practice guideline on the use of automated seizure detection with wearable devices. They recommend using clinically validated devices for automated detection of generalized tonic-clonic seizures and focal to bilateral tonic-clonic seizures, especially in unsupervised patients, where alarms can result in rapid intervention. In this review, we investigate the published evidence behind the guideline, and we outline the need for future research.