Summary: This study presents the clinical and management problems in 81 epileptic patients attending the Queen Victoria Hospital for 98 pregnancies between 1985 and 1988. Epileptic women were found to have a 26.1% risk of seizure deterioration during pregnancy and the single most important factor for predicting seizure prognosis was the severity of epilepsy prepregnancy. There was a significant increase in the complications of vaginal bleeding, preeclampsia, and preterm delivery, compared with a control group of women. Infants of epileptic mothers had an increased incidence of low birth-weight and lower Apgar scores at 5 minutes. The congenital abnormality rate was 14.3% (9 major and 5 minor abnormalities). These results confirm that pregnant epileptic women are a high risk group.