The management of epilepsy in developing countries requires cultural knowledge and approaches beyond the usual practices of western medicine. The heterogeneity of the populations of developing countries translates into a diverse range of beliefs about causes and treatment of illness. This article focuses on explanatory models of epilepsy in cultures throughout Africa, India, China, South America, and the Middle East. The social impact of epilepsy on individuals, families, and communities is examined. The role of traditional healing practices is reviewed, along with policies for allocation of scarce health care resources for the treatment of epilepsy in the developing world.