This chapter summarizes the most relevant metabolic and endocrine circumstances that can trigger isolated situation-related or acute symptomatic seizures. There are few investigations that address the epidemiology of metabolic and endocrine triggering seizures. Metabolic causes for seizures encompass lack of energy, intoxication, impaired neuronal function in storage disorders, and disturbances of neurotransmitter systems with excess of excitation or lack of inhibition. Specific neurological signs or symptoms, dysmorphic stigmata, or other non-neurological clinical findings can help diagnostically. Dialysis disequilibrium syndrome is caused by brain edema after rapid hemodialysis and may present with headache, nausea, vomiting, cramps, tremor, impaired consciousness, and seizures. In seizures caused by hypocalcemia, calcium gluconate is used at a dosage of approximately 1 mg/kg in children. In adults with metabolic or endocrine-induced seizures it is obvious that the underlying cause should be identified and treated if apparent.