Carbamazepine has broad spectrum anti-seizure activity. It is effective in the treatment of psychomotor (partial seizures), grand mal (generalises tonic-clonic) seizures and mixed seizure patterns. Carbamazepine has a number of effects on hematologic system, but the rare and serious adverse effect is aplastic anaemia. A 50 years old female patient was admitted in female medical ward with chief complaints of fever since 3 days which is insidious in onset & gradually progressive, pedal oedema and breathlessness. Past medical history includes patient was a known epileptic since 20 years and is on medication with Tab. Carbamazepine. In order to prevent serious adverse drug reactions of drugs, close monitoring during treatment course, creating awareness, recognition of the patient and careful management of all patients is essential. Physicians should be alert to the possibility of anti-epileptics ADRs, especially carbamazepine associated aplastic anaemia.