This study examined the perceived family reactions and the quality of life in adults with epilepsy in Harare, Zimbabwe. Perceived family reactions refers to behaviors that occur in response to epilepsy. Roy's Adaptation Model was used to conceptualize quality of life in the physiologic, self–concept, interdependence, and role–function modes. Face–to–face interviews were conducted on a convenience sample of 66 adults ages 18–45 years. A three–part structured interview schedule was used to describe demographic data, quality of life (using a modification of the disease–specific Quality of Life in Epilepsy 89 [QOLIE–89] instrument), and perceived family reactions. Quality of life was not adversely affected in the physiologic, self–concept, and interdependence modes but was affected in the role–function mode. Family reactions were positively correlated with the quality of life (r = .39, p = < .01). The effect of the independent variable, perceived family reactions (R2 = .15345, F = 11.60132, p = <.01), explained 15% of the variance in quality of life. Adults with epilepsy were uncertain about their families' reactions, such as overprotection, but felt accepted and supported by their families. Fear, isolation of the individual, secrecy, and concealment were negative strategies used by families and individuals to manage epilepsy. Roy's Adaptation Model was used to identify family reactions as significant and positively correlated to the quality of life of adults with epilepsy. To enhance the quality of life in adults with epilepsy, nurses need to encourage positive family reactions such as openness, acceptance, and support, while discouraging fear, isolation of the individual, secrecy, concealment, and overprotection.