Hair loss is a common adverse effect of antiepileptic drugs, especially in association with valproic acid and carbamazepine. The development of hair loss with newer antiepileptic drug therapy is relatively rare. We present a 15-year-old girl with frontal lobe epilepsy who developed hair loss after two months of topiramate adjunctive therapy. The hair loss was reversible upon discontinuation of topiramate, but recurred after reintroduction of the drug. Hair loss should be considered an adverse effect in topiramate adjunctive therapy. It may have significant cosmetic impact and psychosocial relevance, especially in children and young adults.