In this report the epidemiologic aspects of epilepsy in Arab countries are systematically reviewed. MEDLINE and Embase were searched, and six papers were identified: one incidence report from Qatar and five prevalence reports (two from Sudan, and one from each of Libya, Tunisia, and Saudi Arabia). An incidence of 174 per 100,000 persons in 2001 was reported in a hospital-based study from Qatar. Prevalence ranged between 0.9/1,000 in Sudan and 6.5/1,000 in Saudi Arabia, with a median of 2.3/1,000. An approximate 724,500 people with epilepsy live in the Arab world. All the studies report higher prevalence in males, which was statistically significant in the Saudi study. The prevalence is approximately 2-fold higher in children and young adults, compared to the rates in middle age. Two studies showed a high prevalence in individuals older than 60 years of age. Primary generalized seizures are reported in 28-97% of cases, partial seizures in 3-43.8%, and unclassified seizures in 18-51%. Idiopathic epilepsy represents 73.5-82.6% of cases. Early childhood brain damage such as in cerebral palsy and mental retardation represented a major cause of symptomatic epilepsy, whereas infection was the main cause in Sudan. The epidemiologic data from Arab states are lacking, especially from populous countries like Egypt, Algeria, and Syria. Well-designed studies are needed to accurately determine the burden of epilepsy in the Arab world.