Objective: To test the feasibility and effect of nurse run epilepsy clinics in primary care. Design: A randomised controlled trial of nurse run clinics versus ''usual care.'' Setting: Six general practices in the South Thames region. Subjects: 251 patients aged over 15 years who were taking anti-epileptic drugs or had a diagnosis of epilepsy and an attack in the past two years who met specified inclusion criteria and had responded to a questionnaire. Main outcome measures: Questionnaire responses and recording of key variables extracted from the clinical records before and after the intervention. Results: 127 patients were randomised to a nurse run clinic, of whom 106 (83%) attended. The nurse wrote 28 letters to the general practitioners suggesting changes in epilepsy management. For this intervention group compared with the usual care group there was a highly significant improvement in the level of advice recorded as having been given on drug compliance, adverse drug effects, driving, alcohol intake, and self help groups. Conclusions: Nurse run clinics for patients with epilepsy were feasible and well attended, Such clinics can significantly improve the level of advice and drug management recorded.