We examined self-reported complementary and alternative medicine (CAM) use among a largely indigent population with epilepsy. Overall CAM use was 70%, with the most frequently reported complementary and alternative medicines (CAMs) being medical marijuana (33%), prayer/spirituality (31%), meditation (19%), vitamins (19%), and stress management (16%). Forty-four percent of patients reported improved seizure control with CAMs. Stress management accounted for perceived seizure reduction in 74%, followed by marijuana (54%), prayer (49%), and yoga (42%). Among the most commonly used and helpful CAMs, stress management was not associated with specific demographic or clinical variables; marijuana use was significantly associated with lower age (users = 35.2 +/- 10 years vs. nonusers = 41.6 +/- 12; p < 0.01) and lower income (under $ 15,000 40% use vs. 14% over $ 15,000; p < 0.05); and prayer was significantly associated with female gender (male = 21% vs. female = 45%; p < 0.01) and Black ethnicity (Black = 55% vs. Hispanic = 30% vs. White = 23%; p < 0.05). Taken together, our study was notable for the high rate of CAM utilization in a largely indigent population, with high rates of perceived efficacy among several CAM modalities. (C) 2014 Elsevier Inc. All rights reserved.