Purpose <p>The purpose of this study is to report seizure outcomes for patients with Dravet syndrome (DS) who underwent vagus nerve stimulator (VNS) implantation at our center.</p> Methods <p>We conducted a retrospective review of patients with DS who underwent VNS implant at UPMC Children’s Hospital of Pittsburgh from 2005 to 2024 with at least 1&#xa0;year of follow-up. Demographics and medical history related to epilepsy were collected at baseline. The primary outcome was response to VNS at 1 and 2&#xa0;years post-VNS, defined as ≥ 50% reduction in seizure frequency compared to baseline. The number of anti-seizure medications (ASMs) and diet modification were also collected at 1 and 2&#xa0;years post-VNS.</p> Results <p>A total of 13 patients (69.2% female) with DS underwent VNS at a median age of 4.17&#xa0;years (IQR, 2.58–4.58) and presented for follow-up at 1 (<i>n</i> = 13) and 2 (<i>n</i> = 9) years post-VNS. The response rate in our cohort was 61.5% (<i>n</i> = 8) at 1&#xa0;year and 55.6% (<i>n</i> = 5) at 2&#xa0;years post-VNS. Reduction in the number of ASMs was reported in a total of 7 (53.8%) patients, 4 of whom had reached the 2-year follow-up. Diet modification was attempted as a treatment strategy in 3 (23.1%) patients prior to VNS and maintained through 2&#xa0;years post-VNS in 1 patient.</p> Conclusions <p>VNS is associated with &gt; 50% seizure frequency reduction in approximately 50% of patients with DS and may play a role in the multimodal treatment strategy employed for seizure control in these patients.</p>