Background: Epilepsy is a neurological condition that has proven to be a major public health challenge worldwide, including Zambia. Despite the availability of many treatment alternatives, people with epilepsy still experience seizures. There is paucity of information on the control of seizures and associated factors in Zambia. Methods: A cross sectional study was conducted among epileptic patients at Kitwe and Ndola Teaching Hospitals, two referral hospitals in Northern Zambia, from September 2 to September 23, 2019. We performed a multivariate logistic regression analysis to identify independent predictors of seizure control. Adjusted odds ratios and their 95% confidence intervals are reported. Results: A total of 220 epileptic patients were enrolled in the study. Of these, 23.6% had controlled seizures while 76.4% had uncontrolled seizures. Occupation (p value=0.018), level of education (p value<0.001), clinic attendance (p value<0.001), drug adherence (p value<0.001), belief about drugs (p value=0.006) and having friends (p value=0.025) were significantly associated with seizure control. A higher level of education (AOR:0.243, CI:0.080-0.738), regular clinic attendance (AOR:8.578, CI:3.327-22.112) and age at first seizure of 7-12 years (AOR: 1.035, CI:0.240-4.454) were predictors of controlled seizures. Conclusions and Implications for Translation: Our study showed that there was a low prevalence of controlled seizures among the study population. Key words: • Seizure • Control • Epilepsy • Zambia • Healthcare   Copyright © 2020 Mwansa et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.