ABSTRACT Introduction: Depression and anxiety are the most common mental illness, but both are frequently unrecognized and unmanaged among patients with epilepsy. Objective: To assess magnitude of anxiety, depression and associated factors among patients with epilepsy in Ethiopia, 2018. Methods: An institution based cross - sectional study design was conducted from May 15 to June 24, 2018. Depression and anxiety were measured by using Hospital Anxiety and Depression Scale (HADS). Results: A total of 416 study participants were interviewed with 99.3% response rate and 59.6% of study participants were male. The mean age of the study participants was 33.19 ±13.66 years. The prevalence of depression and anxiety among people with epilepsy was 37.7 % and 39.9 %, respectively. Depression was associated with poor social support, low monthly income, perceived stigma, medication non –adherence, side effects of AEDs and current use of alcohol. Anxiety was associated with poor social support, perceived stigma, medication non –adherence, >= 4 times frequency of seizure attacks per months, and side effects of AEDs. Conclusion: The prevalence of depression and anxiety among people with epilepsy was high. Both depression and anxiety had a statistically significant association with perceived stigma, AEDs side effects, medication non-adherence, and social support. Keywords: depression, anxiety, epilepsy