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One hundred and eighteen adult epileptic patients were registered and followed up for three months while on treatment in the outpatient clinic. The cost of epilepsy treatment was calculated for three months and adjusted for one-year period. Of the 118 patients, 54% had generalized tonic clonic, 13% simple partial, 14% complex partial, 8% myoclonic and 1% absence seizures. In 79% of the patients, interictal electroencepalography and CT Brain were done free of cost and in 22%, the scans were done at a concessional rate between Rs.350 to Rs.750. Generic forms of anti-epileptic drugs were distributed to the patients free of cost once in two weeks. The average cost of anti-epileptic drugs per patient per annum was Rs.204. The average total income per patient per annum was Rs.17,250 (range 0 to Rs.72,000). The total direct cost per patient per annum was Rs.1378 and of this 90% (Rs.1248) constituted travelling expenses to collect the drugs. the total indirect cost per patient per annum was Rs.2254. The direct and indirect costs of epilepsy treatment in a state Government Hospital was low and acceptable to patients below poverty line but unfortunately, the travelling expenditure was high. We suggest that the delivery of anti-epileptic drugs should be at the periphery and not in tertiary hospitals.