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Background/Objectives Antiseizure medications (ASMs) are the mainstay of epilepsy treatment, and may render 2/3 of people seizure-free. Adherence to ASMs is crucial for achieving seizure control. Unfortunately, ‘treatment gaps’ prevent many people from accessing or adhering to ASMs. We aimed to understand the factors that promote and hinder ASM adherence in a high-income country, from healthcare providers’ perspectives, and practical strategies used to address these.Methods Semi-structured interviews were conducted with purposively sampled epilepsy healthcare providers in Australia. Transcripts were inductively coded, thematically analysed, and mapped to the WHO’s Five Dimensions of Medication Adherence framework, using a framework analysis approach.Results Interviews were conducted with sixteen epilepsy healthcare providers, each with 7–35 years’ experience of managing epilepsy, located throughout 6 Australian states and territories. Twenty-three barriers and 16 facilitators were identified across all five dimensions of WHO’s medication adherence framework. Key barriers included lifestyle factors, health beliefs, acceptance of the diagnosis, and long wait times with limited access to services. Facilitators included the provision of tailored, epilepsy-specific information, strong clinician-patient relationships, acting on patient-identified goals and motivators, and integrated health systems. Personalised education and written materials were considered beneficial for patient’s self-management of their epilepsy and adherence to medication regimens. The need for regular reviews and accessible healthcare services to support ongoing adherence was highlighted.Conclusion Addressing modifiable factors that influence ASM adherence is a pragmatic step to addressing epilepsy treatment gaps. Findings from this study may inform the development of practical, point of care interventions to improve medication adherence.