An acute symptomatic seizure is defined as a clinical seizure occurring at the time of a systemic insult or in close temporal association with a documented brain insult (an acute medical or neurological illness). These etiologies may vary with time and place .This study was conducted with an aim to study the clinical profile of acute symptomatic seizures presenting to our RIMS RAIPUR CG,a tertiary care centre at North India. All patients admitted in medicine wards with recent onset seizure either alone or in association with some medical complaints were considered in the study. Detailed history, neurological examination and baseline investigations were done in all the patients. Cerebrospinal fluid (CSF) analysis was done wherever indicated and CT scan / MRI brain were carried out. EEG was done within 48 hours of seizure (if the condition of patient permitted). Total number of patients was 48 (28 male: 20 female). Majority of patients were less than 40 years (n=32) and most common presentation was single seizure (n=24, 51.1%).Status Epilepticus was seen in (n=12, 25.5%). Thirty cases had generalized tonic clonic seizures and 17 had partial seizure. CNS infections was the most common etiology (n=44.7%) neurocysticercosis being the commonest (14/47; 31%) followed by metabolic causes (n=10; 21.3%), post stroke epilepsy (7/47; 14.90%) and brain tumor (3/47; 6.3%). Three had non specific gliosis. Outcome was good in cases with single seizure. Four patients who had status epilepticus expired.