Epilepsy is common among people with learning disabilities, and is associated with other physical and mental disorders and an increased risk of premature death. Effective control of epileptic seizures is crucial, since seizures themselves, their underlying cause and/or treatment may result in significant problems for the individual. Anti-epileptic drugs are the mainstay of treatment, and choice is determined by the type of seizure. Accurate diagnosis is therefore essential, but can be more difficult in people with learning disabilities because communication problems and behavioural disturbance are more frequent than in the general population. Other challenges include swallowing problems, side effects of medication, comorbidity and polypharmacy, and risk management. As professional leaders, epilepsy specialist nurses and neuroscience nurses have a particular role in overcoming these challenges to improve quality of life and outcomes in people with learning disabilities and epilepsy.