Epilepsy is one of the most prevalent non-communicable conditions and also one of the most common neurological disorders affecting approximately 50 million people in the world, about 80% of who live in low and middle income countries (LMIC). It is characterized by recurrent (two or more) unprovoked seizures, with active epilepsy (AE) being defined as at least one seizure in the last 5 years although in LMIC it is often defined when one of the seizures is within 12 months of identification. Epilepsy is associated with significant psychosocial co-morbidities that impact on the healthrelated quality of life of patients and also influence prognosis. In LMIC, the perceptions of causes and consequences of epilepsy may differ from those in the high income countries (HIC) and often lead to stigmatization. The stigma may in turn hide a proportion of the burden of epilepsy since patients are unwilling to seek medical advice, translating into large treatment gaps. Many studies of LMIC have shown that the majority of PWE do not receive appropriate treatment despite the availability of cost effective treatment. The estimates of the burden of epilepsy in LMIC are based upon little data and between and within country estimates vary considerably. Causes of this heterogeneity have not been established but it is thought to be due to differences in methodological approaches, case definitions and ascertainment and lack of validation of screening instruments, as well as genuine differences in the magnitude of the burden of epilepsy.