Background and aim Epilepsy is one of the most common neurological disorders with a huge impact on the physical and psychological well-being of the individuals affected. Unwanted behavioral practices regarding epilepsy emergencies result in poor management, costly clinical interventions, and frequent unnecessary visits to the emergency departments. We aimed at conducting a large-scale investigation of behavioral practices, beliefs, and perceptions regarding epilepsy first aid measures among the Saudi public. Methods This is a descriptive questionnaire-based cross-sectional study of the general public residing in the Southwestern region of Aseer in Saudi Arabia. Results The study included 1230 participants. There were about 70.4% shows good knowledge about epilepsy and 74.2% with good knowledge about epilepsy first-aid. About 87.1% reported that they know what epilepsy really is, and nearly 38.1% know somebody diagnosed with epilepsy. Only 25.4 sought doctors for epilepsy-related knowledge. About 16.7% thought spirit possession to be the aetiology for epilepsy and about 14.1% believed that evil eye was the cause. In terms of the adjusted impact for background factors on epilepsy knowledge, high education, attending seminars, or getting information from doctors was associated with a better knowledge score. However, housewives were less knowledgeable in terms of epilepsy-related knowledge. Conclusion We uncovered in our present investigation the upward trend for behavioral practices regarding epilepsy during the last few years among the Saudi public. We noted that behavioral practices and knowledge levels about epilepsy were far better among highly educated graduates. One concerning finding is the huge reliance on media for information about epilepsy. The media may not be the ideal channel for the dissemination of health-wise information about epilepsy. Our study results showed that there was a very low level of first-hand experience of knowing some acquaintances living with epilepsy, likely because of stigma. Spirit possession and evil-eye beliefs are embedded in the Saudi culture. It was notable that 25% and 19% of minorities reported getting information about epilepsy from doctors and seminars, respectively. These were the two groups with the highest adjustable knowledge score though. Knowledge about first aid for epilepsy was satisfactory in several aspects. Sadly, housewives were less knowledgeable in terms of epilepsy-related knowledge than other categories of employment. Public healthcare facilities should be more proactive. Health education should be provided to the general public using simple and understandable language to help improve knowledge and attitudes towards epilepsy and all related chronic illnesses.