Background: The overarching objective of antiepileptic therapy is to attain optimal seizure control while minimizing the impact of adverse effects. Currently available pharmaceutical interventions for epilepsy treatment exhibit distinctive adverse drug reaction profiles. This study seeks to systematically monitor Adverse Drug Reactions (ADRs) associated with the administration of antiepileptic drugs in individuals with epilepsy. Methodology: Conducted as a hospital-based cross-sectional investigation, this study was undertaken collaboratively by the Department of Pharmacology and the Department of Medicine at Government Medical College, Srinagar. The analysis focused on patients attending the Neurology Department of SMHS Hospital. Causality and ADR allocation were determined utilizing the Naranjo Monitoring Scale and the WHO-UMC Scale. Severity assessment of ADRs was conducted employing the modified Hart Wig and Siegel Scale (1992). Results: Phenytoin, valproate, and carbamazepine emerged as the predominant prescriptions, accounting for 31.3%, 23.1%, and 14.2%, respectively. A total of 121 ADRs, encompassing 35 distinct types, were identified in 68 patients, yielding an overall prevalence of approximately 50.7%. Naranjo's Monitoring Scale categorized 73 ADRs (60.3%) as having a 'probable' causal relationship with the antiepileptic drug, while 48 (39.7%) were deemed 'possible.' According to the WHO-UMC Scale, 44 (36.4%) ADRs were classified as 'possible,' 73 (60.3%) as 'probable,' and 4 (3.3%) as 'unlikely.' All reported ADRs were characterized as mild to moderate in severity based on the modified Hart Wig and Siegel Scale. Conclusion: Healthcare practitioners, particularly those attending to antiepileptic patients, should possess comprehensive knowledge regarding potential ADRs associated with antiepileptic medications. Vigilance is essential for the prevention, management, and alleviation of adverse health effects resulting from ADRs. The establishment of an active pharmacovigilance program is thus imperative for any healthcare institution.