An expert survey conducted among 32 members of the Pediatric Epilepsy Research Consortium, representing 17 pediatric epilepsy centers, sheds light on the current practices of neuromodulation via Responsive Neurostimulation (RNS) and Deep Brain Stimulation (DBS) for treating pediatric drug-resistant epilepsy (DRE). The survey reveals that while four centers implant RNS devices exclusively, the majority (13 centers) utilize both RNS and DBS. Notably, RNS programs are more established, with 13 centers starting their programs by or before 2020, compared to the more recent adoption of DBS programs, with 10 out of 12 beginning after 2020. The annual implantation rate is higher for RNS, with the busiest centers implanting 6-10 devices, whereas all DBS programs implant fewer than five devices yearly. The youngest patient to receive RNS was 3 years old. For surgical planning, most centers (11 out of 12) use advanced MRI sequences. The centromedian thalamic nuclei are the primary target for Lennox-Gastaut syndrome. Surgeons typically gain neuromodulation experience in clinical practice. Complications are rare, with only a few cases of significant hemorrhage or infection reported. Importantly, a significant seizure reduction (>50%) was observed in 81% of the centers. This survey highlights the evolving role of RNS and DBS in pediatric DRE treatment, emphasizing the safety, effectiveness, and growing interest in collaborative research to enhance understanding and practices in this field.