Objective : Adverse effects are leading causes of treatment failure with antiepileptic drugs(AEDs).We studied the cosmetic effects of AEDs and their association with medications adherence and quality of life . Methods : The study was performed on Sudanese epilepsy patients attending Daoud charity (June-September2014).Five main variables were used(1)Cosmetic effects profile;(2)Morisky Medication Adherence Scale(MMAS-8);(3)WHO Quality of Life Brief-26;(4)Socio-demographic data,and (5)Epilepsy related data. A senior neurologist assessed the cosmetic effects through clinical examination of the patients. Consents have been obtained from all patients. Results: Out of 420 patients male were (54.15%) and female were (45.85%),mean age 34.1+-10.4 years. Hair loss was the most commonly reported cosmetic effect by female patients (75%) who were taking sodium valproate.(26.2%)of patients had weight gain and none of them thought weight gain is an adverse effect. Neither of life score, nor adherence score were correlated with any of the cosmetic effects of AEDs (P>0.05).A significant positive correlations was found between the duration from the last attack and the quality of life score (P=0.03). The Gum overgrowth was correlated with hirsutism and Acne(P>0.05). Significance : We concluded that our patients prioritize medications intake in spite of the presence of cosmetic effects, and this-together with absence of association between quality of life and the cosmetic effect-may be attributed to different Sudanese patients perception to these cosmetic effects from other populations in addition to the unique Sudanese culture.