Cognitive impairment is commonly observed in people with epilepsy (PWE), with studies indicating that they tend to score below average on cognitive assessments, and research shows that at least one-third of PWE exhibit some form of cognitive impairment. Importantly, this impairment is not uniform; it varies based on factors such as age, seizure type and frequency, seizure onset zone, duration of epilepsy, and the number of antiseizure medications being utilized. Evaluating cognitive impairment in PWE is crucial for optimizing their management and treatment plans. Tests used to assess cognitive function can be categorized into two main groups: screening tests and neuropsychological assessments. Most antiseizure medications significantly influence cognitive functions in PWE, with lamotrigine and levetiracetam noted for their favorable cognitive profiles. These medications are recommended for managing seizures in individuals who also experience cognitive impairment.