Aim: People with epilepsy often face difficulties finding and keeping a job in India. This study aimed to determine the employment rate of people with epilepsy, compare it with that of people without epilepsy and to assess the various factors affecting theiremployment status. Methods: A comparative cross-sectional study was done by recruiting 140 people with epilepsy and 140 people without epilepsy (relatives of patients) from an epilepsy clinic in New Delhi, India. Demographic and clinical data were collected using questionnaires. Additionally, five items were added to measure self-perceived importance of work, ability to work and family support for working. Psychometric scales were used to measure the psychosocial variables affecting employment. Questionnaires were completed by people with epilepsy. Results: The employment rate of people with epilepsy was 59.3% as compared to 70.0% in those without epilepsy (P=0.045). Gender, younger age, having fewer family members, higher educational attainment, self-perceived importance of being employed for personal and financial reasons, and the ability to work and family support for working were some of the factors associated with employment status in people with epilepsy (P<0.05). Among the psychosocial variables, epilepsy stigma and perceived social support were found to be significantly associated with being employed (P<0.05). None of the clinical variables were found to be associated. Of those in the study, 56 out of 83 people with epilepsy, who had a job, felt they were underemployed. Conclusions: The employment rate of people with epilepsy was lower than the control population. The majority of those with jobs felt they were underemployed. A host of factors affect employment status in people with epilepsy. This suggests the need for vocational training, raised awareness among the general population, and counselling and other services for people with epilepsy.