Tramadol is a synthetic analogue of codeine which has been in the market since 1995. It is a racemic mixture in which the each of the enantiomer is responsible for each of its dual analgesic mechanism. The seizure inducing effect of tramadol is widely studied and reported. The tramadol can provoke seizure in patients with epilepsy and those with no history of epilepsy even with the recommended doses. The other precipitating factors are excessive doses or co-administration with other seizure inducing drugs.