Purpose. The goal of this work was to examine the concerns of living with recurrent seizures as expressed by older adults with epilepsy (OAE). Methods. Thirty-three community-dwelling adults over the age of 60 (mean age = 65, range 60-80) were surveyed as to their concerns living with epilepsy. All patients were being treated for intractable partial epilepsy (mean age at seizure onset = 37, range 1-77) and all were receiving antiepileptic drugs (AEDs). Patients were given a blank sheet of paper and asked to list any concerns they had about living with epilepsy. Each patient listed his or her concerns in order of importance. Results. Twenty-eight different areas of concern were listed by the OAE (range 1-6 per patient). Concerns about driving/transportation (64%) and medication side effects (64%) were the most frequently listed concerns. Other concerns listed by >20% of patients included personal safety (39%), AED costs (29%), employment (26%), social embarrassment (21%), and memory loss (21%). Driving/transportation and AED side effects were the two most important concerns. Conclusions. Quality-of-life issues in OAE appear similar in content to those of younger epilepsy groups. Driving/transportation, role restriction (i.e., grandparenting role), employment, social embarrassment, and safety are major concerns expressed by older adults. However, medication side effects appear more concerning to older adults as compared with earlier studies with younger patients. This study highlights the substantial burden of living with epilepsy in older adults and points to the challenges clinicians have when addressing them. © 2005 Elsevier Inc. All rights reserved.