Objective: To investigate the psychiatric and behavioural symptoms in children and adolescents with epilepsy. Methods: Patients with epilepsy and aged 4 to 16 years were recruited from a medical centre in Azerbaijan during January 2012 to December 2013. A community sample was drawn from 3 schools as the comparison group. The Strengths and Difficulties Questionnaire (SDQ) was administered to parents of both patients with epilepsy and children in the comparison group. The total difficulties score and the scores for each subscale were compared between the 2 groups. Additionally, scores between different groups of epileptic patients were compared. Results: A total of 409 patients with epilepsy and 515 children in the comparison group were recruited. Those with epilepsy had a significantly higher mean total difficulties score and mean difficulties subscale scores (p < 0.001). In epileptic children with severe mental or physical disabilities, prosocial behaviour scores were significantly lower than those in the comparison group. The proportion of children with a total difficulties score in the abnormal range was higher in the epilepsy group than in the comparison group (53.1% vs. 15.7%; p < 0.001). Children with symptomatic epilepsy showed a higher total difficulties score than those with idiopathic epilepsy (p < 0.05). Conclusion: Children with epilepsy have a higher rate of psychiatric and behavioural symptoms. These rates are even higher in children with symptomatic epilepsy.