This study was conducted to explore and compare seizures among alcoholic and non-alcoholic patients in a clinical setting. A total of 200 patients aged 18 to 80 years were included from the Department of Neurology at Narayana Hospitals, Nellore, in collaboration with a 1440-bedded multidisciplinary teaching hospital. The study spanned six months from September 2023 to February 2024 and involved both alcoholic and non-alcoholic patients presenting with seizures. The findings reveal a significant predominance of alcoholic seizures, accounting for 61% of the cases, followed by non-alcoholic seizures at 15.5%, alcohol withdrawal seizures at 11%, and seizures of unknown origin at 12.5%. This distribution underscores the considerable impact of alcohol on seizure prevalence across different patient groups. The demographic analysis indicates a clear age-related pattern, with the 31–40 age group being the most represented among alcoholic patients, while the 41–50 age group is more prevalent in non-alcoholic and alcohol withdrawal patients. This suggests specific age vulnerabilities to seizures influenced by alcohol consumption. Seizure types varied significantly among the patient groups. Alcoholic patients predominantly experienced tonic-clonic seizures (84 cases), whereas non-alcoholic patients exhibited focal to generalized seizures. This difference highlights the distinct seizure patterns related to alcohol consumption and withdrawal. Comorbidities were also a crucial aspect of the findings, with alcoholic patients showing a higher incidence of cerebrovascular events (HTN+CVA) and combinations such as HTN+DM+CVA, indicating a complex relationship between alcohol use and related health conditions. Treatment strategies varied across seizure types. Acute management of alcoholic seizures involved the administration of Diazepam, along with thiamine, magnesium, and multivitamins to address alcohol-related deficiencies. Non-alcoholic seizures were managed with anticonvulsant medications like carbamazepine, valproic acid, levetiracetam, and lamotrigine, supplemented with multivitamins for overall health support. For alcohol withdrawal seizures, benzodiazepines like diazepam and clobazam were used, combined with nutritional supplements such as thiamine and magnesium. The findings advocate for personalized treatment strategies that cater to the specific needs of patients, thereby enhancing overall patient safety and wellbeing. This research bridges the gap between clinical practice and research, offering practical implications for healthcare professionals in managing seizures in alcoholic and non-alcoholic patients