Objective: Non-adherence to antiepileptic drugs (AEDs) is a source of preventable seizures, morbidity, and mortality in patients with epilepsy (PWE). Prospective Memory (ProM), or memory for intentions, has been linked to adherence in chronic illnesses; its relevance to medication management in epilepsy has been largely unexplored. We hypothesized that ProM deficits would be associated with suboptimal AED adherence. Method: Ethnically diverse PWE (N = 51; 57% Female; 57% African-American, 24% Caribbean-American, 22% Latino) completed a ProM measure (Memory for Intentions Screening Test; MIST) and had AED adherence electronically monitored for one-month (Medication Event Monitoring System; MEMS). MIST performance and MEMS results were characterized, and their relationships were examined using (one-tailed) Spearman correlations. Results: On average, participants took AEDs as prescribed 72% of the time (SD = 27.6); 88% of participants missed ≥1 dose and 52% took ≥1 extra dose. MIST Total Scores indicated borderline impaired ProM (Mean Z-Score = −1.63, SD = 2.23) and were significantly correlated with frequency of extra doses taken (rs = −.25, p = .041). Performance on MIST's 24-hour delayed ProM task was also significantly associated with frequency of extra doses (rs = −.31, p = .012). Patients who failed the 24-hour delayed ProM task were AED-adherent 69% of the time, whereas those with full or partial scores displayed 80% adherence. Conclusion: Findings revealed ProM deficiencies in PWE, which were associated with suboptimal AED adherence. ProM assessments, such as MIST's 24-hour delayed ProM task, may offer practical means of identifying individuals at risk of AED non-adherence. Ethnic minority PWE, who are at risk for poor health outcomes, may especially benefit from ProM evaluation and intervention.