Aim: This study was aimed to study about anti epileptic’s drugs utilization pattern and cost effective analysis among children in tertiary care hospital. Materials and methods: In this observational study 71 patients were enrolled from inpatient and outpatient of Pediatrics Department in RMMCH during the study period i.e., from November 2016 to April 2017. Morisky scale, statistical analysis-paired t test were used to assess medication adherence and cost effectiveness respectively. Resources used for the collection of the data include, Patient case sheet and Personal interaction with the patients. Results: The study showed that epilepsy attacks were found to be more common in male (73.24%) than female (26.76%) patients. In this study, majority of patients were on monotherapy (56.3%) and less were on triple therapy (8.45%). Valporate are prescribed more (17.5%) followed by Phenytoin (15%). Medication adherence was improved after patient counseling. Conclusion: The periodic studies on drug utilization pattern of antiepileptics would help in understanding the trends of use in comparison with other reports or facilities and also that more involvement of pharmacist in children care yields better therapeutic outcomes. As our study is the first of its kind this serves as baseline data for future reference.