Recent studies on epilepsy mortality have shown that deaths due to epilepsy would have been preventable in the majority of cases. Over the years, research on epilepsy has prioritized one of the major causes of death, which is Sudden Unexpected Death in Epilepsy (SUDEP). This study pursues a holistic approach and classifies epilepsy-related deaths into direct, indirect, undetermined, and unrelated causes of mortality. It uses a metaanalysis approach and data from eight articles published from 2008-2018. The Standardized Mortality Rate (SMR) is used as the independent variable and the study compares it with rural and urban population data along with the direct and indirect causes of deaths in people with epilepsy. The findings of this study have shown that the standard mortality rates (SMR) in both rural and urban populations are almost the same. Furthermore, the majority of deaths occurring in urban areas are due to unrelated causes, which are unlikely to be preventable, while deaths happening in rural areas, due to indirect causes, are more likely to be preventable. This study suggests that there should be firm guidelines on classifying different kinds of deaths. The findings of this study showed a positive influence of SMR and direct causes are the leading reason behind epilepsy-related deaths (ERD) in the overall population. More than the prevalence of epilepsy, it has been very shocking to see how the death rates have spiked and recognise if these deaths are actually preventable or not in addition to making sure to define all the possible causes of death in epilepsy. From this study, it could be inferred that the majority of the deaths in epilepsy are preventable based on the scenario. This is partly because indirect deaths were relatively higher in both rural and urban areas and these are usually preventable. The study also laid out a complete breakdown of different forms of death in epilepsy mortality which is very often misunderstood due to lack of proper criteria to classify them. According to Devinsky, Singh and Friedman (2018), the major issue that research in epilepsy mortality faces worldwide is the fact of how inaccurate data is recorded for mortality in ERD in any given country. This shows that the procedure lacks to effectively studying epilepsy risk factors for death. In brief, the different causes of death in epilepsy that were discussed previously include direct, indirect, undetermined and unrelated causes. The direct causes of epilepsy are defined as deaths that are a consequence of a seizure. These causes include SUDEP, and status epilepticus. On the other hand, indirect causes of death are the ones where people get harmed as a consequence of a seizure, and the harm could be in the form of burns, injury, and assault etc. The other category is undetermined causes and these are deaths that could not be defined research still needs to address these challenges. The final category is the unrelated causes, where the cause of death is completely irrelevant to epilepsy. The SMR rate did not differ much in terms of both urban and rural areas. The indirect causes of death in rural areas were higher, whereas direct causes showed a significant factor to contribute to the overall death rate. The unrelated and undetermined causes of death were almost the same in both populations. This further explained that studies on mortality should be focusing on having a general approach rather than being particular and overemphasising on SUDEP in particular. This would help to come up with different strategies to prevent these deaths as well. Furthermore, this would prevent carers or PWE to not say that they were not aware of the potential death risks. Since the number of deaths in other causes besides the direct causes were relatively higher, it could be inferred that these deaths are preventable by education, raising awareness, and safeguarding PWE. On the other side, the direct causes of epilepsy-related deaths are the major contributing risk factor for death in urban areas. In order for deaths to be preventable in terms of geographic and demographic location, efforts should be made to have equal access to treatment rather than having disparities due to income and population. This study has demonstrated that there is a need for evaluating the risk factors when diagnosing someone with epilepsy. It could be an extra step, in addition to the diagnosing process, and would look much like an assessment for mortality risk factors. This assessment would help figure out the kind of death a person might potentially fall under will help clinicians and professionals to come up with an assessment of preventive interventions. This step would look into evaluating the risk factors for death and would look more into co-morbidities, medication, and other conditions the person might be having. During this study, it was found that most research focused on how these direct causes are not well explained by medical professionals to PWE and carers. During the screening process for this study, it was found that most studies looked at the adult population rather than the pediatric. Some studies also showed that deaths in the older age group for PWE was significantly larger, due to poisoning and therefore this also has a chance to be prevented. Most of the studies used in the meta-analysis for this study looked into all age groups of people and during the screening process of selecting articles, it was found that there were not enough studies in the older age group for PWE, which could be another area of interest for a future research topic. Due to the study criteria, there were only 8 studies that met the requirement. This explained that there were very few studies that focused on SMR and most studies that were excluded from this study focused on the same country. This means that future studies should look into other countries. In addition to that studies examined the unrelated and undetermined causes of death in this population because this somewhat overlaps with SUDEP. Thus, some studies also failed to compare different causes of mortality in different age groups. The majority of studies that were excluded approached mortality specifically by looking into SUDEP, rather than focusing on death as a whole. Potential mortality-related studies on this topic should cover the premature mortality aspect of death because it is much different from this topic. One of the major drawbacks of this study was that despite classifying the various causes of death, the analysis does not include an in-depth detail on the form of deaths. Another drawback of the study was that the data did not have details on gender. This would be a potential area for research to learn the various risk factors and whether they vary in terms of gender. While diagnosing epilepsy could be a long time-consuming process, people often do not realise how one falls into a greater risk of death due to the other factors from having epilepsy. It is also one of those diseases that take a long time because it gets misdiagnosed majority of the times. It would be ideal to implement something within the treatment to make sure that the risk factors do not get undiagnosed. Interestingly, people who are newly diagnosed and whose epilepsy is controlled are less likely to be prone to death (National Institute of Health, 2019). Current challenges in epilepsy-related deaths are to figure out what potential risks would be applicable to a person because most people are made aware of SUDEP, but they might not be aware of other kinds of deaths that a person might potentially be at risk. It would be very interesting to learn how the focus of epilepsy mortality would change and lead to a direction in the next few years. Over the years there has been a lot of improvement when it comes to preventing epilepsy-related deaths. Most literature has suggested an urgency to make it a priority for medical professionals to communicate the significance of informing families and carers of potential death risks for those with epilepsy. Most importantly a significant gap in this is that not all the potential causes of epilepsy-related deaths are disclosed to the family or carers. Instead, these professionals tend to touch on little bits and pieces like status epilepticus or SUDEP. Furthermore, it would be beneficial if these professionals addressed this issue as a whole. Medical practitioners should inform PWE and carers about every possible risk factors for epilepsy mortality, whereas researchers in this area should have an analytical approach when classifying the different forms of deaths in epilepsy. Furthermore, figuring out the root causes behind epilepsy will also help medical professionals to design an effective treatment option for the diagnosis. The statistics used here showed that there is a need for consistent data collection and comparison studies in this particular research topic that would help to address this issue. This study found that deaths in most cases are preventable but it needs effort in terms of awareness for the public, and an extra step during the diagnosis stage for assessing any death risk a person might have, based on their seizure and other co-morbidities. Overall, this study comes up with a clear understanding of different causes of death and realistically asserts these deaths could be prevented or not.