Introduction: Globally, seizures are common disorders recognized since antiquity and are encountered frequently during medical practice. The highest incidence occurring in early childhood and late adulthood. Currently up to 10% of general population experience at least one seizure in their lifetime with the highest incidence occurring in early childhood and late adulthood. Seizures beginning in the adult life require special attention as regards to their etiology because these are likely to be due to an identifiable and treatable cause. These are mainly trauma, central nervous system infections, space-occupying lesions, cerebrovascular accidents, metabolic disorder and drugs etc. In addition, the etiology and clinical profile of seizures in adults necessitate decisions about the initiation and discontinuation of pharmacotherapy. All patients with adult onset seizures should have a neuroimaging study to determine whether there is an underlying structural abnormality or not. Magnetic resonance imaging (MRI) can identify structural etiology of seizure and guide clinicians in the determination of treatment and prognosis because of its superior sensitivity and specificity. Materials and methods: This was a cross-sectional observational study conducted over a period of 2 years at AMCMET Medical college, Ahmedabad. Data were collected from the young adult onset seizure patients who underwent MRI brain. Patients with previous history of seizure and/mental disability excluded from study. Detailed history and clinical examination, routine laboratory investigations, Magnetic resonance imaging (MRI) and Electro encephalography (EEG) were done on all patients. Results: Out of 200 patients 58% of the patients were between the age group 20-30 years of age, 46.4% were males and 53.5% were females. Majority patients 58.5% had generalized tonic-clonic seizure. Metabolic causes constituted an important etiology (50%) of adult onset seizures. Abnormal EEG and MRI brain were found in 39.5% and 46% of patients respectively. Abnormal MRI findings like, gliosis (5.5%), tuberculoma (5.5%), CVST (5.5%), Medial temporal lobe sclerosis or hippocampal abnormality (5%)Infarct (3.5%)posterior reversible encephalopathy syndrome (3.5%), Neurocysticercosis (3.5%), cerebralatrophy(3%),ICH (3%). calcified foci (0.5%), Hyperintense lesion in right parietal region (0.5%), , Meningioma (0.5%), , subdural hemorrhage and cerebral oedema (2.5%), meningitis (2.5%), SAH (2%), Correlation of MRI and EEG showed that 50.5% had EEG and MRI both normal. 36% had EEG and MRI both abnormal. Conclusion: It was found that no specific etiology to be prevalent in patients with young adult onset epilepsy. Hence a complete work up ranging from proper history taking, clinical features and radiological investigation should be done.