Background: Seizure is a transient occurrence of signs or symptoms due to abnormal excessive or synchronous neuronal activity in brain.1,2 It can present as anything from violent convulsions to unusual experiences that are difficult for others to witness. Objective: Methods: This Cross-sectional study was conducted among patients attending Medicine, Neurology OPD/Patients Admitted in Department of General Medicine, Subbaiah Institute of Medical Sciences, Shivamogga, Karnataka, India. The study was conducted over a period of 1 year after obtaining clearance from institutional ethical committee. Duration of study was August 2022 to August 2023. Result: The mean total cholesterol in patients who received phenytoin was 165.90 ± 23.70 and in patients who received levetiracetam was 113.06 ± 17.22. (p=0.001). The mean HDL-C in patients who received phenytoin was 48.78 ± 9.35 and in patients who received levetiracetam was 45.36 ± 7.07. (p=0.11). The mean LDL-C in patients who received phenytoin was 95.54 ± 13.66 and in patients who received levetiracetam was 72.37 ± 11.45. (p=0.001). The mean triglycerides in patients who received phenytoin was 148.07 ± 33.11 and in patients who received levetiracetam was 101.38 ± 9.22. (p=0.001) Conclusion: patients on phenytoin displayed elevated serum lipid profile levels (TC, LDL-C and TG). Thus, TC levels, LDL-C levels and TG levels can be an important marker for estimating the risk of cardiovascular disease in epilepsy patients