Epilepsy is often associated with cognitive and behavioral impaiments that can have a profound impact on the quality of life of people with epilepsy. Cognitive impairments in epilepsy are present in both people recently diagnosed with epilepsy and those with long-term seizures. The relationship between seizures and cognitive impairments is complex and involves a multifactorial origin that can be influenced by etiology, genetic determination, age, electroencephalographic abnormalities, duration, type of seizures and frequencywhich has a different impact on the course of cognitive development. The most common cognitive areas affected in epilepsy are: memory, attention, language,intelligence and executive functions. Cognitive impairments differ from one extreme to another: there are mild cognitive deficits in people with controlled seizures, and moderate or even severe cognitive deficits in people with refractory seizures. This review article provides a comprehensive overview of the cognitive impaiments in epilepsy, the causes and the risk factors.We think that this information can contribute to theidentification and prediction of the cognitive risk, which can influence the outcome and treatment and can have an impact on the quality of life of the people with epilepsy and their families.