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Epilepsy was considered to be commonly associated with aggression historically. It has also been emphasized in medicolegal settings. However, the link between epilepsy and directed aggression is now noted to be less clear-cut even though brief and non-directed aggression can occur not so uncommonly. Aggression in epilepsy could be linked to a number of factors including seizures or the underlying electrophysiological activity of the brain, neuropsychiatric comorbidities, antiepileptic drugs or underlying brain damage which may cause aggression and epilepsy both. Common clinical presentations of aggressive behaviors in epilepsy and their pathogenesis are discussed. A clinical approach to assess and manage these problems is described and related evidence is discussed.