Background - Epilepsy is the world’s most common neurological disorder, affecting approximately 50 million people worldwide and contributed to different psychiatric illness. Depression is one of the most frequent co morbid psychiatric disorders that affects the life of the patients. This comorbidity in people with epilepsy impose significant burdens on patients and their families. The study aimed to determine the prevalence of depression and associated factors among peoples with epilepsy in Mekelle , Ethiopia. Methods – An institutional based cross-sectional study was conducted among systematically selected 296 people with epilepsy from April 15, 2019 – May 30, 2019. Depression was assessed by using the Patient health questionnaire (PHQs). The data were entered & clean by using Epi Info 4.4 version. Statistical Package for Social Sciences version 25 was used for analysis. Factors with a p-value < 0.30 in the bivariate logistic regression were entered into the multivariate model. A p-value of less than 0.05 was considered statistically significant. Result - The prevalence of depression was found to be 34.8%. Unable to read & write (AOR= 0.400, 95% CI: 0.162, 0.986), long duration of the medication intake at least for 11 years (AOR= 3.715, 95% CI: 1.498, 9.212), absence of improvement with medication (AOR= 0.216, 95% CI: 0.101, 0.460), feeling of perceived stigma (AOR= 0.244, 95% CI: 0.129, 0.462), stress symptoms( AOR= 0.452, 95% CI: 0.220, 0.928), were significantly associated with depression. Conclusion – Nowadays depression among peoples with epilepsy is high. Keywords:- Comorbidity, Depression, Epilepsy, Outpatient, Mekelle.