Background: The present study was conducted for assessing 50 epileptic patients treated with sustained release valproate. Materials & methods: The present study was conducted for assessing 50 epileptic patients treated with sustained release valproate (SRVPA).In this study, patients between the ages of 10 and 75 having a confirmed diagnosis of epilepsy and using SRVPA as monotherapy were included. Following the initial medication, the patients were requested to return for follow-up reviews at the second week, the first month, the third month, the sixth month, and at successive half-year intervals. Time to treatment failure was the main outcome of this study, along with other AED discontinuation due to ineffectiveness, discontinuation of SRVPA due to ineffectiveness [LE], intolerable adverse events [IAEs], ineffectiveness combined with intolerable adverse events [LE & IAEs], poor adherence, patients' financial hardship, or a pregnancy plan. A patient who had low compliance was one who had voluntarily stopped receiving SRVPA treatment. Following a statistical analysis using SPSS software, all the results were entered into a Microsoft Excel spreadsheet. Results: Mean age of the patients was 30.8 years. 56 percent of the patients were males while the remaining were females. Most common type of epilepsy found in the present study was cryptogenic type. Majority of patients had two or three seizures. Treatment failure was encountered in 30 percent of the patients. Common reasons for treatment failure were lack of efficacy, adverse events, poor compliance and financial hardship. Conclusion: Lack of efficacy, intolerable adverse events were the most frequent reason for treatment failure.