Abstract Objective The vaccine is the greatest weapon in the battle against the coronavirus disease (COVID) pandemic. Even though COVID-19 vaccines are considered safe in people with epilepsy (PWE), a sizable proportion of PWE are concerned about the safety of vaccines such as precipitation of seizures. The aim of this study was to assess the frequency of COVID-19 vaccine administration, factors affecting the vaccine hesitancy, and side effects of vaccine among PWE. Materials and Methods In this cross-sectional analytical study between December 2021 and August 2022, we included PWE > 15 years attending the epilepsy clinic irrespective of gender. We recorded the demographic and clinical details, COVID-19 vaccination status, and vaccine hesitancy. Those who had received two doses were considered as fully vaccinated. Results We recruited 226 participants with a median age of 31.5 (15) years. Ninety-six (42.5%) PWE were women and 153 (67.7%) were of rural domicile. Only 96 (42%) had received two or more doses of any COVID-19 vaccine. After vaccination, 45 (30.8%) PWE complained of at least one general side effects and five PWE experienced seizures. Fear of precipitating the seizures was the most common reason for hesitancy in 39 (49%), whereas 26 (33%) PWE were deferred by health care workers. None of the factors such as age (p = 0.366), age of onset of seizures, gender (p = 0.167), domicile (p = 0.090), educational status (p = 0.619), and seizure characteristics (p = 0.675) were associated with vaccination status. Conclusion Only 96 (42%) PWE were fully vaccinated against COVID-19 and fear of worsening of the seizure frequency was the most common reason for the vaccine hesitancy. Vaccination was associated with seizures in five PWE. A multicentric population-based study may give better information.