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Summary: Background: Epilepsy is a common but widely misunderstood illness. Consequently, epileptics suffer from considerable stigmatization in society. Since no studies have detailed the misperceptions about epilepsy in our community, it is not possible to provide focused intervention aimed at eliminating this prejudice. Purpose: To assess the knowledge and attitude regarding epilepsy in an adult population of a Karachi slum area. Methods: A face-to-face interview was conducted on 487 consenting adult non-epileptics (305 males; 182 females) who were conveniently sampled. Chi-square test was employed to calculate the variability in knowledge and attitude with demographic and other variables. Results: In all, 12.5% had never heard about epilepsy. Among the rest, 66.7% identified epilepsy as being non-infectious, while 28.2% were unaware of any treatment available for it. Among the other 71.8%, 62.7% were aware of the existence of anti-epileptic drugs. Religious/spiritual treatment was chosen as the most effective treatment by 33.1%. Males were more likely to identify epilepsy as being non-infectious (p =0.02). Nearly 18% of the respondents would not object to their child marrying an epileptic, 69.5% did not want to socially isolate the epileptics, 83.1% said epileptics could receive academic education, 85.6% said they could perform activities of daily life and 62.4% said they could become useful members of the society. Those who considered epilepsy to be infectious were more likely to carry negative attitudes towards epilepsy (p <0.01 with four attitudes). Conclusions: Considerable gaps exist in the community''s knowledge about epilepsy. Some of these may explain the prevalence of negative attitudes towards this ailment. [Copyright &y& Elsevier]