Background: Headache is a commonly reported comorbidity in individuals with epilepsy and their relationship is still incompletely known. Objective: To assess the most prevalent kinds of primary headache and their connection to seizure timing among patients with epilepsy. Patients and methods: This is cross sectional study, we assessed headaches using a comprehensive medical history, physical and neurologic examination, EEG, CT, and MRI brain scans in 200 patients with idiopathic epilepsy who were seen at the Mansoura University Hospital's neurology outpatient clinic and epilepsy clinic. Results: Of our study population, tension-type headache (TTH) occurred in 57% of patients, unclassified headache in 22% of patients, migraine occurred in 19% of patients, migraine and TTH in 2% of patients. There were 4 patients (2%) had a pre-ictal headache, 2 patients (1%) had an ictal headache, 156 patients (78%) had a postictal headache and 31 patients (15.5%) had an interictal headache and 7 patients (3.5%) had an inter-ictal-post-ictal headache. Headache frequency was associated with female sex, anxiety, sadness, generalized tonic-clonic epilepsy, high seizure frequency, and antiepileptic polytherapy usage. Conclusion: A major comorbidity of epilepsy is headache, particularly TTH, which should be given extra attention, particularly in female patients, patients receiving polytherapy, patients experiencing more frequent seizures, and patients with generalized tonic-clonic epilepsy.