Background: Despite medical advances, almost a third of people with epilepsy have medically refractory epilepsy (MRE). With failure of pharmaceutical options, patients are turning to alternative treatment options. Marijuana use in epilepsy has received extensive attention. Two recent studies evaluated the opinions of marijuana use in individuals with epilepsy, but had discrepant marijuana use rates. Methods: The first 200 adult patients with a known diagnosis of epilepsy seen at Hamilton General Hospital after June 1, 2017 were invited to participate. Standardized paper questionnaires gathered information about demographics, epilepsy history, and marijuana use. Results: One hundred forty participants returned questionnaires; 29.5% were active marijuana users; 24.5% had consumed marijuana in the past. Increased seizure frequency was significantly associated with marijuana use. There was a non-significant trend towards increased marijuana use with males and MRE. Almost half the active marijuana users noted improvement in seizure frequency. No participants experienced worsening of epilepsy with marijuana use. Side effects were common (30%), most frequent being mood. Conclusions: Prevalence of marijuana use among people with epilepsy is higher in our study population compared to an Australian cohort, but similar to Canadian studies. Marijuana use was significantly associated with increased seizure frequency. The majority of patients perceived benefit with regard to seizure control.