Background: Epilepsy is a prevalent neurological disorder marked by recurrent seizures, which can significantly impact quality of life. Understanding how epilepsy is managed in healthcare settings, particularly by nurses who play a critical role in direct patient care, is essential. However, knowledge gaps and varied practices exist among nurses, influencing their efficacy in managing epilepsy patients. Objective: This study aimed to assess the knowledge, attitudes, and practices regarding epilepsy among nurses in a tertiary care setting, with a focus on identifying areas of strength and those needing improvement. Methods: A descriptive cross-sectional study was conducted at Jinnah Hospital, Lahore. The sample comprised 138 registered and diploma nurses working in medical, surgical, and emergency units, excluding head nurses, student nurses, and those in outpatient departments. An adapted questionnaire was employed to evaluate knowledge about epilepsy, attitudes towards patients, and practical care approaches. Data analysis was performed using descriptive statistics in SPSS version 25, with checks for data normality and distribution. Results: The age distribution of participants showed 50.0% (69 nurses) within the 31-35 age group, 73.2% (101 nurses) were females, and experience levels varied with 53.6% (74 nurses) having 1-5 years of experience. Knowledge assessments revealed that 60.9% correctly identified epilepsy as non-contagious, yet misconceptions about epilepsy being a mental disorder were evident in 29.7% of responses. Practice-related responses indicated proper seizure management actions were inconsistently recognized, with only 29.0% knowing to avoid inserting objects in the patient's mouth during a seizure. Conclusion: The study identified critical gaps in the knowledge and practices of nurses regarding epilepsy care, emphasizing the need for targeted educational programs to enhance nursing competence in epilepsy management. Effective training could lead to better patient outcomes and reduce misconceptions associated with the condition.