Misconceptions about epilepsy may explain the considerable stigma accompanying it. We aimed to identify such fallacies through questionnaire-based interviews of 487 adult residents of a slum area in Karachi, Pakistan. Of those interviewed, 25% believed that epilepsy was caused by evil spirits, black magic and envy by others - those without a school education were more likely to hold these views (P < 0.05). Perceived complications included impotence and cancer. Shoe-sniffing was considered a treatment modality by 13%. It appears that misconceptions abound regarding epilepsy's causes, complications and methods of treatment. However, those who had received a school education were less likely to link epilepsy with supernatural phenomena.