Introduction: Epilepsy is one of the most common serious chronic neurological conditions affecting people of all ages globally, Around 50 million people worldwide have epilepsy, of whom nearly 80% live in low- and middle-income countries. The treatment gap (percentage of people with epilepsy whose seizures are not being appropriately treated at a given point in time) is, estimated at 75% in low-income countries and is substantially higher in rural than in urban areas. Wide treatment gaps may result from a combination of lack of capacity in health care systems, inequitable distribution of resources and low priority accorded to epilepsy care Objectives The main aim of the study is to assess the treatment outcome of epilepsy and associated factors among epileptic patients at neurology follow up TGSH, BahirDar, Ethiopia Methods hospital based cross-sectional study using semi structured questionnaire and patient chart review was employed at TGSH. Data was cleaned, coded, and analyzed by using SPSS version 25. The results was displayed by using frequency tables and charts. logistic regression was used to test the association of variables Epilepsy treatment outcome was evaluated in terms of seizure control status in the last one year follow up period. . Results total of 384 patients were included. Of whom, 66.6% had uncontrolled epilepsy. Being illiterate AOR [adjusted odd ratio (AOR): 7.541, 95% CI: 2.303_–24.688], living in rural residency [AOR: 10.743, 95%CI: 2.763–41.77, presence of triggering factor (AOR 67.187,CI 20.473-220.487) were perdictors of poorly controlled epilepsy. . also being female is 88 times more likely associated with uncontrolled epilepsy(AOR:0.127,95%CI0.043-0.378 Conclusions the finding of this study revealed that two third oof the epileptic patients had uncontrolled seizure. Epileptic patients who are illiterate, female, and whom from rural area, were more likely to have uncontrolled seizure. Key words; treatment gap, seizure Freedom Introduction: Epilepsy is one of the most common serious chronic neurological conditions affecting people of all ages globally, Around 50 million people worldwide have epilepsy, of whom nearly 80% live in low- and middle-income countries. The treatment gap (percentage of people with epilepsy whose seizures are not being appropriately treated at a given point in time) is, estimated at 75% in low-income countries and is substantially higher in rural than in urban areas. Wide treatment gaps may result from a combination of lack of capacity in health care systems, inequitable distribution of resources and low priority accorded to epilepsy care Objectives The main aim of the study is to assess the treatment outcome of epilepsy and associated factors among epileptic patients at neurology follow up TGSH, BahirDar, Ethiopia Methods hospital based cross-sectional study using semi structured questionnaire and patient chart review was employed at TGSH. Data was cleaned, coded, and analyzed by using SPSS version 25. The results was displayed by using frequency tables and charts. logistic regression was used to test the association of variables Epilepsy treatment outcome was evaluated in terms of seizure control status in the last one year follow up period. . Results total of 384 patients were included. Of whom, 66.6% had uncontrolled epilepsy. Being illiterate AOR [adjusted odd ratio (AOR): 7.541, 95% CI: 2.303_–24.688], living in rural residency [AOR: 10.743, 95%CI: 2.763–41.77, presence of triggering factor (AOR 67.187,CI 20.473-220.487) were perdictors of poorly controlled epilepsy. . also being female is 88 times more likely associated with uncontrolled epilepsy(AOR:0.127,95%CI0.043-0.378 Conclusions the finding of this study revealed that two third oof the epileptic patients had uncontrolled seizure. Epileptic patients who are illiterate, female, and whom from rural area, were more likely to have uncontrolled seizure. Key words; treatment gap, seizure Freedom