OBJECTIVES: Epilepsy is a chronic health problem with major implications for mortality, morbidity, productivity and wider economy. Epilepsy places a high cost on the Social Security Institution (SSI) of Turkey. This study estimates the direct cost of epilepsy treatment in Turkey. METHODS: In the absence of a database to estimate direct costs from real world data, a Delphi panel approach was adopted. Questionnaire form was designed to explore the type, amount and duration of resources used in treatment of epilepsy. The form stratified cost items by epilepsy type (focal, generalized and unclassified). Five key opinion leaders with a wide knowledge of clinical practice in Turkey completed the form. All direct costs for diagnosis, treatment, monitoring, emergency and hospitalization were included. The costs of resources used in each category and in each treatment modality were calculated by using the SSI’s price tariff, cost year 2016. RESULTS: The annual weighted average cost per patient for different types of epilepsy was calculated as 5,700 TL. Drug costs are attributable for a relatively low proportion of the total cost of treatment, 2,605TL for patients with partial epilepsy (46%), 1,774 TL for generalized epilepsy (31%) and 495.45 TL for unclassified epilepsy (9%). The current number of patients with epilepsy in Turkey is estimated as 776,959. According to expert views 48% of these are with partial, 39% with generalized and 13% with unclassified epilepsy which corresponds to an estimated total annual direct cost of epilepsy to the SSI of 4,428,666,300TL CONCLUSIONS:  Epilepsy is a debilitating disease both for the patient and the society. The total annual direct cost of epilepsy to the SSI in Turkey accounts for approximately 10% of the SGK health care budget. Effort is required to improve seizure control in treatment refractory patients to improve patient outcomes and reduce the current economic burden.