Introduction: Epilepsy affects almost 50 to 70 million individuals worldwide, accounting for 0.75 percent of the worldwide illness burden. Every year, an approximately of 2.4 million individuals are afflicted with epilepsy. Due to a lack of accessibility and affordability of AEDs, up to three-quarters of patients with epilepsy in low-income nations are unable to receive the medication they require. Aim: To determine the factors influencing antiepileptic drug (AED) nonadherence in a tertiary care hospital. Methodology: According to the findings of a single-center, cross-sectional investigation, we did a subgroup assessment. Patients have to be at least 18 years old to participate. The Morisky Medication Adherence Scale, which has four items, was employed to assess compliance to AEDs. To forecast parameters linked to AED nonadherence, researchers employed multivariable logistic regression assessment. Results: This subgroup evaluation includes a total of 270 patients who met the eligibility criteria. Amongst the patients, 82 (31%) did not take their medication as prescribed. AED polytherapy, medication-linked negative events, and medication length beyond 3 years were three characteristics linked to poor adherence. Conclusion: Almost one-third of the participants did not take their medicine as prescribed. Noncompliance may be minimized if patients__ampersandsignrsquo; treatments are limited to monotherapy as much as feasible and patients are taught about the length of medication and potential side effects of AEDs.