Background: reproductive health issues of women with epilepsy (wwe) are complex and multifaceted, and both epilepsy and antiepileptic drug (aeDs) use may alter fertility and pregnancy outcomes in these women. Objective: to determine the fertility rate of women with epilepsy at Kenyatta national Hospital (KnH). Design: cross-sectional study. Setting: neurology clinic, KnH, nairobi, Kenya, between october 2006 and march 2007. Subjects: a total of 191 women with epilepsy (aged 15-49 years) who had been epileptic for at least one year were interviewed regarding their pregnancy and birth histories, and the information validated with medical records where available. Results: the general fertility rate (GFr) for reproductive-aged epileptic women for the three-year period (2003-2006) preceding the study was 46 livebirths per 1000 women-years (95% ci 35.13- 63.59). Conclusion: Fertility rate in epileptic women is decreased by two thirds (compared to that of general population of women in Kenya). reasons for this are probably miltifactorial