Levetiracetam is a pyrrolidine derivate that is approved for the treatment of seizures. It has a favourable pharmacokinetic profile, no clearly established pharmacological interactions, good tolerability and offers the possibility of rapid treatment. We describe a case of pancytopenia and multiple infections observed in the context of levetiracetam treatment. A 65-year-old woman who underwent surgical removal of a meningioma developed progressive pancytopenia complicated by pneumonia and multiple liver abscesses after starting levetiracetam therapy. Bone marrow aspiration and biopsy confirmed the diagnosis. A gradual spontaneous recovery of normal haematopoiesis followed discontinuation of levetiracetam.