OBJECTIVE: To evaluate the psychometric properties of disease-specific quality of life (QOL) instruments in epilepsy. METHODS: A comprehensive search for epilepsy-specific QOL instruments identified 13 metrics using MEDLINE, Pubmed, International Pharmacy Abstracts, Google and reference lists. QOL instruments were included in the study for evaluation if there was at least one publication using the instrument including psychometric data, in addition to instrument availability. Instruments were evaluated based on criteria developed by McHorney and Tarlov (1995) and Davis and Pathak (2001). The seven domains considered in the evaluation were: item information, practicality, breadth and depth of health measured, reliability, validity, and responsiveness. RESULTS: Of the 13 QOL instruments identified, adequate data was available to evaluate five based on study criteria. The five epilepsy-specific QOL metrics were: Quality of Life in Newly Diagnosed Epilepsy (NEWQOL), Epilepsy Surgery Inventory (ESI-55), and the Quality of Life in Epilepsy Inventory (QOLIE) series (-89, -31, and -10). None of these five QOL metrics satisfied all the study criteria. The QOLIE-31 reported adequate or better performance in six of the seven domains assessed (omitting instrument breadth). The QOLIE-10 reported adequate or better performance in five of the seven domains assessed (omitting instrument breadth and internal consistency). The QOLIE-10 and -31 offer practical advantages over the longer QOLIE-89 metric with QOLIE-31 showing superior psychometric properties based on study results. CONCLUSIONS: Epilepsy is a chronic, socially stigmatizing condition with potentially significant affects on patient QOL. A variety of instruments have been published in the literature with QOLIE-89 most commonly used. Of the data available for QOLIE series, the length of the QOLIE–89 limits its use in clinical decision making, while the brevity of QOLIE–10 reduced instrument reliability, as a result, QOLIE-31 is preferred.