Cognitive dysfunction is one of the comorbid diseases frequently seen in patients with epilepsy. Patients with cognitive dys- function are difficult to manage and often lead to deterioration in their quality of life. This can sometimes be more devastating than the seizures themselves. Often these cognitive impairments are multifac- torial. Although the cause of cognitive impairment in patients with epilepsy is not fully understood, known factors include underlying eti- ological causes, seizures themselves, side effects of drug therapy, and psychosociocultural causes. For these reasons, anti-seizure medications make significant contributions to behavioral and cognitive functions, mostly negatively, but rarely positively. The most common central ner- vous system side effects observed during antiseizure medication ther- apy are sedation, drowsiness, distraction, insomnia, and dizziness. The most important factors that increase the risk of cognitive side effects are; multiple anti-seizure medication use, high anti-seizure medication dose, and increased serum drug levels. Adverse cognitive effects can be avoided by slow titration to the lowest effective dose and avoiding poly- therapy. Therefore, clinicians should be alert to side effects by select- ing anti-seizure medications with the best cognitive and behavioral profile according to their needs, starting with the appropriate dose and titration, and evaluating cognitive function using neuropsychological tests. Neuropsychological monitoring is necessary to improve individ- ual medical care in children with epilepsy and to prevent learning dif- ficulties and social problems. In this review, the effects of classical and new generation anti-seizure medications on cognitive functions will be evaluated in detail in children with epilepsy.