Seizure precipitants, which precede the onset of an epileptic seizure, are considered responsible for an epileptic attack. The ultimate goal of treating patients with epilepsy (PWE) is to maintain a seizure-free state with the appropriate treatment. Despite the anti-epileptic treatment, some patients may continue to experience seizures. This study aimed to study the seizure-provoking factors to generate evidence-based information for better management of patients. A facility-based cross-sectional study was conducted at two major referral hospitals with large patient flow in Addis Ababa, Ethiopia, from October 2018 to September 2019. PWEs who had been receiving anti-epileptic treatment before the study were consecutively enrolled until the desired sample size was reached using a convenient sampling technique. A total of 184 PWEs were enrolled. The prevalence of precipitating factors among epilepsy patients was 94%. The most commonly reported precipitating factors were stress (70.1%), missing anti-epileptic dose (57.1%), and inadequate sleep (32.1%). Our findings unveiled factors that precipitate seizures in PWEs and demonstrated the potential of avoiding these factors to reduce the incidence of seizures. It is therefore essential to increase patients’ awareness to focus on non-pharmacological therapy in addition to their regular treatment for better management.