Background: Pattern of treatment outcome can be categorized based on the effect of anrnintervention on seizure control in relation to occurrence of adverse effects. A minimum of 12rnmonths of seizure freedom from all types of seizure is required to label a treatment outcome asrnseizure freedom. Predictors of seizure treatment outcome can be utilized to direct resourcesrntowards strategies that lead to good seizure outcome. Despite the availability of interventionsrnwhich can control the seizure frequency to an extent of 70% a large number of epileptic patientsrncontinue to have a seizure. rnObjective: Patterns of treatment outcome of epilepsy and associated factors among patients onrnfollow-up at adult neurology clinic at Tikur Anbessa Specialized Teaching Hospital: Hospitalbasedrncross-sectionalrnstudyrnOctoberrn1-30,rn2020G.CrnMethods: A hospital-based cross-sectional descriptive study is conducted among epilepticrnpatients who have a follow-up at the Neurology department referral clinic, Tikur AnbessarnSpecialized Hospital, Addis Ababa from Oct 1-30. A convenient sampling method was used. A rnquestionnaire including, sociodemographic status, is used to assess patterns of treatment outcome rnwith associated factors. The data were entered, processed, and analyzed using SPSS 26 windowrnversion. rnResult: A total of 245 participants were included in the study. More than half 145(59.2%) ofrnpatients with epilepsy were in the age range of 15-30. Among participants male gender accountrnfor 113(54.3%) and female gender for 112(45.7%). The age of onset of a seizure was below 15rnfor 115(46.9%) of patients. Generalized onset seizures 154(62.9%) was the commonest type of seizure diagnosed. Comorbidity is seen in 110(44.9%). Monotherapy 68(27.8%) was commonlyrnused for treatment of seizure. The 166(67.8%) of patients had developed antiepilepatic relatedrnadverse event. Antiepileptic dugs non adherence seen in 68(27.8%)of patients. In 41(16.7%) ofrnpatients there is no seizure attack after initiation of antiepileptic medications. Seizure freedom was seen in 99(40.4%) of patients. Sex (adjusted odds ratio (AOR)= 3.316,rnCI=1.044-10.534;p-value=0.042) was predictor of poor seizure control. rnConclusion: In this study, it was found that more than two-thirds of the participants continue tornhave seizure activity despite being placed on antiepileptic medications. Still, a large proportionrnof patients are not adherent to the medication prescribed. The older generation of antiepilepticrnmedications utilized and more than half of patients reporting adverse events. Male sex is found tornhave a three times higher risk of developing poor seizure control. A further multicenter study ofrndifferent subgroups of treatment is recommended and effect of sex on seizure can be studiedrnfurther.