The incidence of sexual dysfunction is high in epileptic subjects, but its etiology is unclear. The aims of the work were to estimate the prevalence of sexual dysfunction in epileptic patients and to determine the factors associated with it. We conducted a cross-sectional, descriptive and analytical study over a 3-month period, including patients treated for epilepsy at the neurology department of the Gabès hospital. We used the Arizona Sexual Experience Scale to assess sexual functioning, the Neurological Disorders Depression Inventory for Epilepsy to screen for depression, and the Liverpool Adverse Events Profile to measure drug toxicity. The prevalence of depression was 20%. Sexual dysfunction was observed in 47.5% of cases. Erectile dysfunction was the most common disorder in men, while in women, desire was the area most affected. Risk factors for sexual dysfunction were: type of generalized motor seizure, duration of epilepsy, polytherapy, depression and drug toxicity.