We searched data from PubMed, PMC, Science Direct, Google Scholar, and by hand searching, on 30 September 2021, using combination of keywords associated levetiracetam, carbamazepine and its efficacy, measured by seizure free rate at 6 and 12 months and adverse drug event such as agitation, diarrhea, and skin rashes in epileptic patients. We included randomized clinical trials (RCTs) performed in patient newly diagnosed with partial or generalized seizures with clear focal origin or generalized tonic–clonic seizures without clear focal origin, experienced more than 2 unprovoked seizures separated by at least 48 hours during the past year with at least 1 seizure during the previous 3 months with no age restriction, publications are limited to English manuscripts that were published in the last 20 years. We excluded studies that only explored one of the two drugs, cohorts, case report and case series. All studies are reviewed and evaluated by all 5 authors. The quality of each included studies was assessed using JADAD Scale.