Epilepsy is the major neurogenic disorder seen in childhood and adolescents with extensive impact on patients' life. Epilepsy and its treatment have a direct bearing on major aspects of life style. The interest in systematic assessment of the health status of patients with epilepsy, using standardized questionnaires has increased. Demographic, social and economic factors might affect health status assessment among epileptic patients (children and adolescents). The objective of this study was the evaluation of some aspects of health status among epileptic children and adolescents mainly through quality of life scoring. A case control study was done; 150 epileptic patients with idiopathic epilepsy and 100 controls with age and sex matched collected from kasr El-Aini out patient clinic. Assessment of the groups was by social level scoring, IQ scoring, identification of their health related quality of life score level for both groups. Clinical examination and laboratory tests for the manifestation of drug intoxication were done for patients only, and also measuring the serum level of anti epileptic drugs for selected patients. Age ranged from 8-20 years with no statistically significant difference between patients and controls (p = 0.1). The majority of patients (61.3%) lie in the age group of 15 to 20 years. Males were presented more but with no significant difference between patients and control groups. There is no significant difference as regards sex distribution (p= 0.41).The majority of included subjects were living in slum areas (46.7% of patients and 49% of controls), then urban areas (37.3% of patients and 37% in controls) followed by rural areas (16% in patients and 14% in controls). Most of patients and control lied in the middle social and the least were among high social. The difference between patients and control subjects were found to be statistically insignificant (p = 0.64).Eighty percent of patients were attending educational institutes versus 90% of controls. The difference between two groups was found to be statistically significant (p < 0.05). No statistically significant difference between the groups regarding consanguinity was found (p = 0.627). Moreover, highly statistical significant difference was observed between groups regarding family history (p < 0.001).The IQ of patients had a mean of 82.8 ± 6.4, while among controls it was 91.6 ± 6, the difference was statistically highly significant (P<0.01).Most patients had secondary generalized seizures. Patients with daily seizures represented 15.3%, 26.7% with weekly seizures, 32.0% with monthly seizures and 26.0% of patients didn't have seizures in the past year. Most patients (40.0%) had their last fit(s) within the last month. Majority of patients with generalized fits (82.0%) and had no relation to sleep. About 55% of patients were on monotherapy treatment while 30% were receiving polytherapy treatment. The majority of patients were compliant to treatment, while 15.3% were non compliant or with no treatment.The mean scores of all domains of quality of life were significantly lower in patients compared to controls (p < 0.01) except for health perception. In patients group the lowest mean score was found for attitude towards epilepsy while the best was detected in school behavior. For the control group the quality of life scores were lowest for physical functioning and highest for health perception. The mean systemic toxicity score among patients group was 2.9 ± 7.2 while the mean neurotoxicity score was 2.3 ± 6.4. It was found that 27.4% had systemic toxicity, 15.3% had neurotoxicity and 31.3% had both systemic and neurotoxicity. According to the serum level of AEDs, patients with subtherapeutic level were 39.1%, while 43.5% of patients had therapeutic serum level and 17.4% were with toxic serum level.Comparisons and correlations among studied groups revealed that:There were no statistically significant difference between males and females as regards the level of education and IQ. However, female patients had lower mean scores in all domains of quality of life as compared to males; and the difference was statistically significant as regards attitude towards epilepsy, epilepsy impact, stigma, anxiety and total score (p < 0.05).The educated group had better scores in all domains and the total score of quality of life except in stigma and anxiety. Patients who lived in rural areas had lower quality of life scores in each domain and the total score except in social support. Also, patients with very low social level had significantly lower scores in physical functioning, epilepsy impact, stigma, anxiety and total score in comparison to other groups (p< 0.05), while those with high social level had significantly lower score in a health perception in comparison to other group (p< 0.05).Patients with positive family history had lower mean score than patients with negative family history in almost all domains of quality of life except in social support score.Epileptic patients who had focal fits had the best score in all quality of life domains and the difference was statistically highly significant (p<0.01). On the other hand, patients with primary generalized fits have the worst scores in different quality of life domains except in social support, attitude towards epilepsy and stigma. However, Patients with generalized fits only during sleep had much better scores in all quality of life domains as compared to the group of patients with generalized fits not related to sleep with statistically highly significant difference (p< 0.01). Epileptic patients who had daily fits had the lowest scores in nearly all quality of life domains except in social support where the score was closely related to other groups with no statistical significant difference. Patients with weekly and monthly fits have closer scores to each other while the best scores were seen among patients with controlled epilepsy more than one year. Epileptic patients who had fits in the last four weeks showed the lowest score in all quality of life domains and total quality of life score compared to other groups.The better score of quality of life domains were among patients who received monotherapy more than those under polytherapy as the worst score recorded for them in attitude towards epilepsy.Toxicity scores correlated significantly with type of epilepsy whether systemic or neurologic (p<0.05). The highest toxicity score was among patients with generalized fits. Patients with polytherapy had the highest toxicity score and the difference between groups was statistically significant (p<0.05).There was no statistical significant relation between serum drug level and toxicity manifestations either systemic or neurologic, also the duration from last fit or frequency of seizures (p > 0.05).There were no significant correlations between age and all quality of life domains among patients group except in school behavior which showed positive significant correlation (p<0.05).Positive correlation was shown between quality of life domains and IQ score except in stigma which showed a negative correlation. The IQ showed significant negative correlation with both the duration from last fit and frequency of seizures. However, IQ was correlated with the type of seizure, the focal type showed the worst score with statistically significant difference among groups (p<0.05).There was significant correlation between age and systemic toxicity; the younger the age the more the systemic toxicity manifestations. Also, high significant negative correlation was shown between toxicity scores and most quality of life domains (p<0.01).