Background: Epilepsy is a common neurological disease especially in Sub-Saharan Africa. Medication adherence is key in seizure control; however, majority of patients have poor adherence to ant- seizure medications which consequently lowers their performance in daily activities. Objectives. To determined the prevalence, factors associated with and experiences on adherence to anti-seizure medications . Methods: In across-sectional mixed methods study 277 participants were enrolled and 20 in-depth interviews conducted. Medication adherence was determined by self-report. Modified Poisson regression was used, and unadjusted and adjusted prevalence ratios (PR) at 95% confidence intervals determined with p-values of less than 0.05 were considered significant. Thematic analysis was conducted to analyze in depth interviews Results: The overall level of adherence to anti-seizure medications was 66.7%. Factors associated with adherence to anti-seizure medications were: Earning a modest monthly income (aPR 1.24: CI 1.05-1.46), adequacy of treatment dosage (aPR 1.24: 95% CI 1.05-1.47), good health provider follow-up level (aPR 1.57: CI 1.28-1.92), waiting time, ( aPR 0.73: 95% CI 0.55-0.95) and being 25 to 34 years (aPR 0.78: CI 0.62-0.96). The key themes on experiences to adherence to anti-seizure medications were fear of stigmatization, injury and loss of life, social support, financial burden, individual motivation, misconception about ASMs and lack of awareness on the effectiveness of anti-seizure medications (ASMs). Conclusion: This study revealed that about two thirds of PLWE were adherent to ASMs. There is a need to implement strategies including a medication adherence tool, increased support and sensitization compaigns to improve ASM adherence so as to improve the quality of life of and performance in activities of daily life among persons living with epilepsy.