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Introduction. The reported mortality rate of epilepsy in Asia ranged from 2.5-5.1, but there was no published data in Malaysia. This study aimed to find out the mortality rate of patient with epilepsy in University Malaya Medical Centre (UMMC), a tertiary hospital in Malaysia. Methods. There were 2389 patients with epilepsy recruited retrospectively from 2009-2018 in this study. Fatal cases were identified from National Registry Department Malaysia. Age- specific and gender-specific Standardized Mortality Ratio (SMR) were calculated. Results. There were 175 deaths (7.33%). The all-cause overall SMR is 1.6 (CI 95% 1.4-1.8). The SMR in the younger age groups (15- 19, 20-29, 30-39 and 40-49) were higher than the older age groups. Overall SMR for male patients (1.8, CI 95% 1.5-2.2) was higher than female (1.3, CI 95% 1.0-1.6). However, in specific age groups (15-19, 20-29 and 30-39), the SMR in female was higher. Conclusion. The mortality rate of epilepsy in Malaysia is higher than the general population in Malaysia but lower than other Asian countries. Specifically, the rate is higher among the males and younger age group.