Background: Patients with epilepsy develope a wide range of medical and neurologic disorders, compared with the general population. The association between epilepsy and atherosclerosis is not clearly defined. Several studies claims that epileptic patients may have the risk to develop atherosclerosis. Methods: This study included 40 adult epileptic and 40 control subjects. For all, Common carotid artery intima media thickness (CA-IMT), fasting lipid profile, serum uric acid (SUA), C -reactive protein (CRP) and glutathione peroxidase (GPX), were assessed. Results: Total cholesterol (TC) ,low density lipoproteins (LDL), Total Triglycerides (TG) ,CRP, GPX were significantly higher in patients compared to control. CA-IMT was significantly higher in epileptic patients treated with antiepileptic drugs (AEDS) compared to control group. The longer the duration of AEDs the thicker was the CA-IMT. Conclusions: Our results heightened atherosclerotic risk in patients with epilepsy on AEDS.