Objectives: To determine the distribution of various epilepsies and epileptic syndromes in the people with epilepsy (PWE) in view of limited published data from rural population of India.

Material and Methods: A cross sectional, hospital based study was conducted among 500 PWE. The diagnosis of epilepsy and epileptic syndromes was established under the guidelines of the International League Against Epilepsy 2010.

Results: Among 500 PWE 340 (68 %) were male. Mean age was 27.19±17.5 years. Age ranged from 8 months to 93 years. Structural –metabolic (53.2 %) etiology was the most common underlying causes followed by electroclinical syndrome in 26.4 % and 6.4% had a distinctive constellation. Central nervous system (CNS) infections were noted in 16.2%, epilepsy with generalized tonic– clonic seizures in 15% and pre–/perinatal insults in 12.2 % of PWE.

Conclusion: Overall the most frequent etiologies of epilepsy in present study were central nervous system (CNS) infections, epilepsy with generalized tonic– clonic seizures and pre–/perinatal insults. Genuine hard work must be done to prevent the occurrence of epilepsy with prevention and successful treatment of infections along with up gradation of the pre/ perinatal care.