Cognitive deficits and psychological impairments are often associated with seizures. In order to describe the neuropsychological profiles of adult patients with epilepsy (PWEs) in Hong Kong China, a total of 186 PWEs were recruited with 102 being drug-responsive and 84 being drug-resistant. Symptoms of depression, anxiety, and epilepsy-specific quality of life (QOL) were measured. Cognitive assessments consisted of intelligence, memory, verbal and visual abilities, and executive function. Neurocognitive impairments were prevalent among PWEs, and patients with drug-resistant epilepsy had significantly more impaired psychological and cognitive profiles. Thirty-nine percent and 30% of patients with drug-resistant epilepsy reported moderate to severe levels of anxiety and depression, respectively, versus 16% and 7% of patients with drug-responsive epilepsy. The most commonly occurring cognitive deficit was memory. Thirty-five percent to 47% of patients with drug-resistant epilepsy and 26% to 35% of patients with drug-responsive epilepsy were compromised in verbal recall memory. Our findings also suggested significant correlations between psychological well-being and cognitive performance. Patients who reported more psychological symptoms tended to perform worse in neurocognitive tests. Identification and management of neuropsychological difficulties in PWEs are important and should be included in primary epilepsy care.