Background: Epilepsy is one of the most common chronic neurological disorders in childhood and is associated with significant neurological, developmental, and psychosocial consequences. Understanding the etiological spectrum and clinical characteristics of pediatric epilepsy is essential for early diagnosis and effective management. Objectives:To evaluate the etiology and clinical characteristics of epilepsy among children attending the Department of Neurology, Government Medical College, Amritsar. Materials and Methods: A hospital-based observational cross-sectional study was conducted among 80 children aged 1 month to 18 years diagnosed with epilepsy. Detailed demographic, clinical, electroencephalographic (EEG), neuroimaging, and etiological data were collected using a structured proforma. Seizures were classified according to the International League Against Epilepsy (ILAE) criteria. Data were analyzed using SPSS version 26.0, and associations between variables were assessed using the Chi-square test, with p < 0.05 considered statistically significant. Results: The mean age of the study population was 8.7 ± 4.3 years, with males accounting for 58.8% of cases. The 6–10 years age group constituted the largest proportion of participants (32.5%). Generalized tonic-clonic seizures were the most common seizure type (53.8%), followed by focal seizures (30.0%). Developmental delay was observed in 26.3% of children, while 17.5% had a positive family history of epilepsy. EEG abnormalities were identified in 76.3% of patients, with generalized epileptiform discharges being the predominant finding (36.3%).  Conclusion: Structural etiologies constitute the predominant cause of childhood epilepsy in this population and are significantly associated with focal seizure presentations. Comprehensive clinical evaluation, EEG, and neuroimaging are crucial for accurate etiological diagnosis and optimal management of pediatric epilepsy.