Introduction: Non-adherence to antiseizure medications is one of the main reasons for treatment failure and seizure recurrence. Objective: Evaluation of adherence and association with belief about antiseizure drugs in patients with epilepsy were examined. Materials and methods: This was a prospective, cross-sectional study of patients with epilepsy in the neurology department for six months. Patient adherence and persistence in long-term treatment continuation were assessed using the Modified Morisky Adherence Scale and Beliefs about Medicines questionnaire scale. Results: A total of 100 patients were enrolled out of which (46%) of the patients were adherent, 54% were non adherent to their medications. GTCS was the commonest seizure (58% ), followed by partial seizures (41% ) and unclassified seizures (1% ). Levetiracetam(37% ) was the commonest drug prescribed, followed by valproic acid(24% ), carbamazepine(19% ), oxcarbazepine(14% ), phenytoin(5% ), phenobarbitone (1% ). Male patients were found to be more adherent to drug therapy as compared to females. \((p< 0.05)\). Participants with higher education were highly (73% ) adherent to antiepileptic drugs, followed by high school (37% ) and primary school 33% ). The specific necessity score was significantly higher in the adherent group than the nonadherent group. Patients who believed that antiepileptic drugs do more harm than benefit were significantly more in the nonadherent group. Conclusions: Patient with high educational status, positive attitude, and belief toward therapy were found to be more adherent to their medication. Assessment of adherence to medication and counseling should be a routine part of management for better health care and quality of life.