There is a growing interest in recognizing the association between antiepileptic drugs and reduced bone mineral density. Although the literature regarding this association has been available for more than three decades, the management of this complication remains unclear. We review the relevant literature regarding antiepileptic drugs and reduction in bone mineral density with the aim of developing some guidelines for practical management of this problem. This review focuses on the mechanism of antiepileptic drug-induced bone loss, its recognition, and its management.