Background: Home-based neurophysiological monitoring is improving the assessment and management of neurological conditions such as epilepsy. Technologies such as electroencephalography (EEG), electromyography (EMG), and accelerometry are increasingly integrated into wearable systems for at-home use. Due to an increasing amount of data from long-term monitoring, machine learning algorithms assist in automated data analysis. However, ensuring device accuracy, signal quality, and user compliance remains crucial for clinical useability. Objective: This chapter explores advances and challenges in at-home neurophysiological monitoring, with a primary focus on EEG systems and their applications. Content: The discussion highlights the technological advances and the challenges associated with at-home monitoring. The focus will be on EEG systems, as well as a discussion of EMG in epilepsy. Next, we will provide an overview of the clinical applications for home-based monitoring of epilepsy and sleep disorders. Lastly, we will briefly discuss emerging topics within home-based monitoring in movement disorders and neurodegenerative disorders. Conclusion: Future advancements are expected with new generations of wearable systems capable of providing long-term monitoring with minimal maintenance. Beyond epilepsy and sleep disorders, home-based technologies are also being investigated in other neurological diseases including movement disorders and neurodegenerative diseases showing the expanding scope of home-based technologies in neurology.