OBJECTIVES: There is a need for early identification and intervention of Adverse Drug Reaction (ADR) to alleviate unacceptably growing burden, morbidity and mortality associated in People With Epilepsy (PWE). This study is aimed at identifying factors associated with ADR and medication adherence among patients in PWE. METHODS: It is a cross-sectional questionnaire-based study consisting of 940 consenting participants aged 16 years and above attending epilepsy clinics for period of 5years with diagnosis confirmed by International League against Epilepsy (ILAE) criteria and supported by Electroencephalography (EEG). 21-item Liverpool Adverse Effect Profile (LEAP) and 8-item. Morinsky Medication Adherence Scale (MMAS) were used to assess ADR and adherence respectively. RESULTS: The highest reported ADR in PWE were nervousness (34.3%), aggression (33.6%) and weight gain (32.3%). Specifically, (20.1%) of the participant complained of memory problem, while the lowest were hair loss (7.2%), trouble with mouth (8.9%) and problem with skin (9.3%). Using the MMAS, 545(90.2%), 28(4.6%) and 31(5.1%) of PWE in this study were classified as having high, medium, and low adherence, respectively. Duration of AEDs use and duration of epilepsy were the major determinant of ADR in PWE on regression model. CONCLUSION: Duration of AEDs use and duration of epilepsy are the major determinant of ADR in PWE. Effective strategies to identify and reduce ADR should be incorporated to management of PWE by Health Care Providers to improve their quality of life. Furthermore, physician should aim towards reducing the duration of AED use and the epilepsy.