Approximately one third of new cases of epilepsy have their onset before age 20 years. Many children will enter adolescence with epilepsy or have an onset of seizures during adolescence. Adolescence is a time of dramatic change in growth, hormonal, psychologic, and social situations. Seizure frequency, teenage pregnancy, driving, and alcohol and drug use often become major issues during the adolescent years. Furthermore, adolescents often have difficulty accepting the chronicity of epilepsy and complying with medications, which can result in physical injury and perceived or real obstacles to employment, thereby contributing to low morale. Both pediatricians and neurologists should be aware of adolescent issues in epilepsy.