Topiramate is a newer drug with a strong antiepileptic potential, but also with adverse effects, especially on cognitive functions. This review deals with the study covering the impact of topiramate on cognition in patients with epilepsy. The most common side effects are included somnolence, psychomotor slowing, difficulty in memory, concentration and attention disorder and problems with speaking. Most studies have shown that a high initial dose, rapid titration and application in polytherapy increase the risk of cognitive impairment after-introduction of topiramate. In addition, depression and early onset of the disease can also contribute to cognitive adverse effects, even at low doses of the drug. Although topiramate indisputably linked to the risk of interference cognitive impairments, some studies suggest their reversibility. This, together with high efficiency antiepileptic obliges researchers to continue searching for the risk factors and mechanisms of cognitive side effects in order to define the profile of patients who would be of maximum benefit of the drug in controlling seizures with absent or acceptable side effects.