The direct costs associated with epilepsy management were evaluated. Patients and methods: Prospective, observational study conducted over 6 months in patients over 14 years of age with epilepsy. Patients with concomitant diseases that could influence epilepsy were excluded. The direct medical costs included: number of neurology, primary care and A&E visits; number and type of diagnostic tests; days of hospitalisation; and treatment administered for epilepsy. The non-medical direct costs were associated with transport to and from hospital and the use of psychological and social support. Result: 171 patients were analysed. The mean cost of anti-epileptic drugs was 513.6 €. The mean cost of medical visits and hospitalisations was 322.3 €. The cost of investigations per patient was 174.8 €. The mean total direct medical costs were 1,010.4 €, with the drugs being the most significant item. The mean non-medical direct costs were 45 €. Average direct costs totalled 1,055.2 € per patient, and medical costs were the most significant item. Conclusions: the use of anti-epileptic drugs is a heavy burden for the health service. The expenditure on medical visits, hospitalisations and investigations in epilepsy is higher than the health service’s mean annual expenditure per patient.