Background Epilepsy is a common condition worldwide and has been observed to affect quality of life. Epilepsy patients have a lower quality of life than the general population as well as many other chronic disease patients. However, aside from focusing on symptom reduction, no attention is paid to the quality of life of those with epilepsy. This study aims to evaluate quality of life and associated characteristics among epilepsy patients who visited North Shoa zone hospitals in Ethiopia. Methods An institution-based cross-sectional study design was conducted from April -May 2021 at North Shoa zone hospitals. A systematic random sampling technique was used to get a total number of 472 samples. Data on quality of life was assessed through interviews using the World Health Organization Quality of Life—Brief (WHOQOLBREF) Version. The collected data were coded, entered into Epi Data 3.1, and analyzed by using SPSS version 25. Simple and multiple linear regression analysis models were fitted and the unstandardized β coefficient at 95% confidence interval was employed. The statistical significance was accepted at p-value <0.05. Results From a total of 472 participants the response rate was 98%. The mean score of quality of life was 57.2±12.3. Age (β=5, 95% CI: 2.301, 7.699), marital status (β=-6.914, 95%CI: -8.867, -4.961),seizure frequency (β=-.2.307, 95%CI: -4.795, .020), Anti-epileptic drug non-adherence (β=-.11.016, 95%CI: -13.642, -8.389), anxiety (β-4.062, 95%CI: (-6.503, -1.621), poor social support (β=-6.220, 95%CI: (-8.422, -4.017) and moderate social support (β=-5.58, 95%CI: -7.792, -3.368) were significantly associated with quality of life. Conclusion The mean quality of life of people living with epilepsy in this study was low. Age, marital status, seizure frequency, concomitant anxiety, antiepileptic drug non-adherence, number of anti-epileptic drugs/day, moderate and poor social support were all found to be predictors of quality of life in this study. As a suggestion, the patient treatment plan should include a quality of life assessment that addresses psychosocial concerns; professional counseling on how to cope with psychological, environmental, and social difficulties should be increased.