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Objective: The aim of this study was to examine seizure frequency and psychosocial outcomes in patients with epilepsy (PwE) during the COVID-19 pandemic. Methods: This cross-sectional case-control study included 319 adult PwE and 327 healthy controls (HC). The data were collected using a patient/person information form, Worry and Anxiety Questionnaire (WAQ), Beck Depression Inventory (BDI-II), and the Pittsburg Sleep Quality Index (PSQI). Results: Seventy-four (23.1%) patients had an increase in seizure frequency during the pandemic. The mean age of PWE with increased seizure frequency (ISF) was lower (32.8±9.3) than PWE with unchanged seizure frequency (USF) (37.0±11.4). When psychosocial impacts of the pandemic were compared between the groups, the ISF group was psychologically affected more than the USF and HC groups. WAQ and BDI-II scores were higher in ISF than USF and higher in USF than HC group. Also, the analysis revealed that the seizure frequency during the pandemic was almost similar before the pandemic. However, only those who had frequent seizures before the pandemic had worsened seizure frequency during the pandemic. The analysis showed that factors such as having trouble in drug supply, having more than 4-6 seizures in a year, worrying about seizure intervention, and being depressed, were related to being psychologically affected by the pandemic. Conclusion: It was observed that the psychosocial outcomes during the pandemic were worse in PwE than healthy controls, especially in those with increased seizure frequency. Therefore, it is essential to increase the medical and psychosocial support to PwE during the pandemic. [ABSTRACT FROM AUTHOR]