Data on the incidence of and prognosis for epilepsy in sub-Saharan Africa are scarce, but prevalence data show that epilepsy is two or three times more common than in industrialised countries in non-tropical areas. The high prevalence of epilepsy and low life expectancy indicate that incidence is high. Relative contributions of each cause of epilepsy are difficult to determine. Only a few case-control studies have been done in sub-Saharan Africa. Infections, in particular cysticercosis in its endemic areas, cause most cases of epilepsy. The implementation of studies to accurately determine the causes of epilepsy in sub-Saharan Africa is urgently required. Such studies will help to lower the incidence of epilepsy in this region and better understand the aetiology of epilepsy in other areas.