Long term antiepileptic drugs (AEDs) side effects are a common concern in people with epilepsy. AEDs are suspected to be associated with several somatic and psychiatric adverse events. This review focuses on long term somatic adverse events and the difficulties of assessing their exact association with AEDs. Most AEDs have been suggested to induce, at varying degrees, bone metabolism changes, increased cardiovascular risk factors, or endocrine disturbances. These findings are however probably biased by the fact that epilepsy itself is associated with a greater burden of somatic comorbidities, regardless to the exposure to AEDs.