Purpose: Prescription pattern may have changed with advent of newer antiepileptic drugs. Cost of management remains the important reason responsible for treatment gap. Current study was done observe prescription pattern and cost of epilepsy management to the patients. Methods: A prospective observational questionnaire based cross sectional survey was conducted in neurology OPD for 12 months. A demographic profile and prescription data of AEDs for past 1 year were collected from diagnosed cases of GTC, CPS and SPS for at least 1 year of treatment. WHO indicators were used for analyzing current prescriptions and direct and indirect cost of treatment for past 1 year was analyzed. Results: A total of 275 AEDs were prescribed to 138 patients. GTC was most common condition with 43.47%. Average no. of AEDs prescribed per encounter was 1.99 with 52% of newer AEDs. Phenytoin was commonly prescribed (24%) for GTC and SPS with secondary generalization. Valproate was commonly prescribed for CPS while carbamazepine for SPS. Average consultation time was app. 15 minutes. App. 98% of patients had correct knowledge of drug dosage. An average total cost borne by patients was Rs. 14589 per year which constitutes to 53% of per capita income. Conclusion: Older antiepileptic drugs are still commonly prescribed drugs. High prescription of brand names and prescription of drugs outside of hospital formulary as only limited drugs are available on schedule list, may be the reason for cost burden to epileptic patients.