Epilepsy is a common chronic neurological disorder, which warrants prolonged, and often lifetime, treatment with AEDs. It is commonly associated with hyperhomocysteinemia, a known risk factor for vascular diseases, and which is also related to several other neurological diseases. Homocysteine is an experimental epileptogenic, and nearly 20% of patients with homocystinuria suffer from fits. Hyperhomocysteinemia in epileptic patients is probably related to administration of AEDs.The aim of our present study is to assess the relationship between treatment with classic anti-epileptic drugs and serum homocysteine level, and to outline the impact of this relationship on patient control and management.Accordingly we studied 40 patients with the diagnosis of idiopathic epilepsy, who were classified into 3 subgroups; group A which included 10 epileptic patients with newly diagnosed epilepsy or patients on no treatment for at least 6 weeks as a control group, group B which included 15 epileptic patients with controlled seizures and group C which included 15 epileptic patients with uncontrolled seizures. Subjects recruited in the study were subjected to the following: Thorough history taking and neurological examination. Routine laboratory investigations. AEDs serum level determination for patients receiving AEDs. Homocysteine serum level determination. Seizure severity scale estimation. Electroencephalography. Further research: Long term effects of AEDs with or without folate supplementation with respect to seizure control, cardiovascular disease, cognitive performance and mood. Effect of newer AEDs on homocysteine to evaluate their relative safety in cases of feared hyperhomocysteinemia. A prospective study of patients initiating AEDs monotherapy can provide information from intra-patient measurement of homocysteine which can outline the individual AEDs effect on homocysteine.