The aim of this systematic review is to identify and synthesise the current literature on the quality of life (QoL) of older adults with epilepsy. Studies were included if they (1) assessed the QoL of older adults (2) had a minimum of one population group of people with epilepsy aged 60 and older and (3) used a standardised QoL measure. Databases searched were PubMed, Scopus, Cochrane Library and PubPsych. A total of 201 abstracts were screened, of which 10 articles met the criteria. A 17-item standardised checklist was used to analyse the methodological quality of the studies. This checklist was derived from other systematic reviews which analysed the QoL of those with other health conditions and modified to suit the purpose of this review. The findings were synthesised to compare the overall QoL of older adults in comparison to younger age groups and to identify which QoL factors were the most and least negatively impacted by the presence of epilepsy and old age. Predictors of QoL were identified from findings that used a regression analysis and were rated regarding their strength of evidence. No clear differences for overall QoL were found between older and younger people with epilepsy. Participants reported energy/fatigue to be the most negatively impacted factor. Seizure frequency was a strong predictor of QoL, and comorbidity and depression were moderate predictors. The modest number of studies available for synthesis is a reflection of the gap in current literature on this topic. Future research needs to include more variables within their regression analysis to identify more predictors of QoL, and needs to compare QoL changes over the trajectory of older age.