In recent years several new anti-epileptic drugs have been introduced, also for the treatment of childhood epilepsy. A major concern is their effect on learning and cognitive development. Testing the genuine effects on cognition of the anti-epileptic drugs is methodologically not easy. At this moment there are very few controlled trials that systematically examine the cognitive side effects of anti-epileptic drugs in childhood epilepsy. The available data indicate that the newer anti-epileptic drugs have a safe cognitive profile when prescribed correctly at the right dose and in monotherapy. Possible negative effects are mainly found for speed of processing and attention processes. As these processes are important instruments in every day learning and cognition, it is necessary to test these newer anti-epileptic drugs in well designed studies and in specific childhood epilepsy syndromes.