OBJECTIVE： To investigate clinical efficacy and safety of levetiracetam add-on therapy in the treatment of elderly epileptic patients. METHODS： Totally 88 elderly epileptic patients in Chongqing Yunyang County Hospital of TCM during Jan. 2014-Jan. 2016 were divided into observation group and control group according to random number table， with 44 cases in each group. Control group was given routine antiepileptic therapy of carbamazepine+phenobarbital； observation group was additionally given Levetiracetam tablet with initial dose of 0.25g， increasing to 0.5 g according to disease condition， bid， on the basis of control group. Treatment courses of 2 groups lasted for 6 months. Clinical efficacies， GCS score， Barthel index score， MoCA score and the occurrence of ADR were observed in 2 groups. RESULTS： Total response rate， control rate and MoCA score of observation group were significantly higher than those of control group， with statistical significance （P＜0.05）. GCS and Barthel index score of 2 group after treatment were significantly higher than before treatment， and those 2 scores of observation group were significantly higher than those of control group， with statistical significance （P＜0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS： Levetiracetam add-on therapy is better than routine therapy plan in the treatment of elderly epilepsy， and significantly reduce coma degree， increase daily living ability and cognitive function with good safety.