SUMMARYIt has been suggested that patients with epilepsy and particularly those on long‐term anticonvulsant medication may have a lower than expected risk of Ischemic heart disease. The records of a cohort of patients with epilepsy in Rochester, Minnesota were reviewed to ascertain their rates of occurrence of Ischemic heart disease. The results did not show any relative decrease in the incidence or mortality rates due to Ischemic heart disease among men or women with epilepsy. The numbers of Ischemic heart disease incidence and mortality cases were 25 and 15, respectively, relative to corresponding expected values of 15.0 and 15.7 new and fatal events. The use of anticonvulsant medications did not appear to influence the rates of Ischemic heart disease among the patients with epilepsy. Subgroups of the epilepsy patients, by etiology and types of epilepsy, were not found to account for a disproportionate share of the Ischemic heart disease. The survivorship of epilepsy patients after the initial manifestations of Ischemic heart disease was comparable to that expected among all Ischemic heart disease patient