Elderly and young patients with epilepsy are at risk for fractures from seizure and antiepileptic drug (AED) related falls and from epilepsy and AED related lowered bone mass. Enzyme inducing AEDs are often implicated, although, nonenzyme inducing medications may also impact epilepsy bone disease. Screening for bone health with direct measures, such as bone densitometry by dual-energy x-ray absorptiometry (DEXA) and indirectly via biochemical markers of bone turnover may help identify patients who are at increased risk for fractures and offer an opportunity for intervention.