In African countries, epilepsy is an important public health problem with major medical, socio-cultural, and economic implications. This study was carried out to evaluate attitudes towards epilepsy in the Central African Republic. A total of 187 epileptic patients were included. Only 20.9% of the study population were married. School attendance never exceeded the elementary level. Epilepsy was active in 98.4% of patients who continued to present attacks despite extensive treatment which was either poorly complied with or inadequate. Attitudes towards epilepsy remain rooted in belief in supernatural phenomenon and evil spirits with use of traditional therapies involving abstinence from certain foods and use of laxative agents to drive out evil forces. Epileptics are excluded from their families and not allowed to attend school but, in our study, they were not prevented from the work place since 70% held jobs. In this study, 54% of epileptics believed that the disease was contagious, 55.6% that it was incurable, and 20.9% that it was due occult or supernatural causes. While precise quantification is impossible, our experience based on interviews with patients and frequent observation of burn wounds suggests that moral and physical suffering is immense among epileptics in the Central African Republic. Epilepsy in Black Africa is a major public health problem requiring serious attention from government officials, health care specialists, and the families of patients. Better information to promote awareness of the non-contagious nature of the disease, greater support for families of patients, and improvement in treatment compliance are essential.