OBJECTIVES: To evaluate, from patients’ perspective, the relative importance of attributes related to epilepsy and the AEDs used to treat it, as well as the role of those attributes on adherence behaviour and quality of life (QoL).  METHODS: Patients with epilepsy from seven countries completed a discrete choice experiment online choosing between AEDs with varying attributes including concentration problems, mood changes, balance problems, sleepiness, weight gain, seizure frequency, and out of pocket cost. These six attributes were identified for inclusion through a review of the literature and product labels.  Attribute levels were combined in an orthogonal design. Respondents also completed three instruments measuring QoL, health state utility (HSU) and medication adherence: QOLIE-31-P, EQ-5D-5L, and MMAS-8, respectively.  Tri-level attributes were transformed to a continuous scale.  Choice data were analysed using a mixed-logit model.  Willingness to pay was estimated through marginal rates of substitution and using purchasing power parities.  Regression methods explored the association between preferences, QoL, and adherence.  RESULTS: Patients (n=660, 100% completion rate) completed the survey. All attributes were significant predictors of choice except sleepiness.  Respondents were significantly more likely to choose a treatment that provided a 10% reduction in seizure frequency (Odds Ratio [OR]=1.75, 95% CI 1.68-1.82) or avoided weight gain (3lb) (OR=0.751, 95%CI=0.731-0.772).  Respondents were willing to pay an additional £39 and £20 per month for AEDs with those attributes. Furthermore, respondents who become unresponsive during a seizure placed higher levels of preference on an AED that would reduce seizure frequency.  Respondents who reported higher levels of adherence to their AEDs (MMAS-8) reported better quality of life (QoL) (QOLIE-31-P and EQ-5D-5L). CONCLUSIONS: Seizure reduction is the most important AED attribute to epilepsy patients, but lack of weight gain is also valued.  Higher adherence to AEDs appears to be linked with improved QoL.