Background: Epilepsy is a common neurological disorder affecting about 70 million people worldwide, with 80% in resource-limited countries. The primary healthcare in these countries is extremely under-resourced, few standard antiepileptic drugs (AEDs) are commonly used and there are concerns about the quality of these AEDs. Objective: We aimed to assess the quality of AEDs gathered from delivery structures, where patients could buy these drugs, in rural and urban areas in Kenya and Gabon. Methods: It was a cross-sectional study assessing AEDs gathered from public, private and illegal circuits. Analyses were carried out in France following Pharmacopeia recommendations. Several tests (active ingredients assay, related substances screening, mass uniformity, dissolution, disintegration and friability) were conducted to assess the quality of the AED. A further screening with mass spectrometry and nuclear magnetic resonance was performed for fake AEDs and/or those found containing unknown compounds. Results: In both countries, 61 boxes of AEDs were gathered (5% of diazepam, 25% of carbamazepine, 33% of phenobarbital, 10% of phenytoin and 28% of sodium valproate). Of the 61 boxes, 72% (44) have been completely analysed. Of these 44 boxes analysed, 95% met the required quality standards and 5% were fake-drugs. In particular, one batch of phenobarbital and one of phenytoin from illicit market in Kenya did not have active ingredients, but unknown compound (unidentified as yet). Conclusion: A small proportion of poor quality AEDs was found in these African countries. Illicit circuit appeared to be the most involved, this might be due to poor storage conditions.