Background: Childhood epilepsy has increased in global incidence. Children with epilepsy require immediate healthcare evaluation and monitoring. Waiting times between first seizure onset and pediatric neurology assessment may impact seizure outcome at follow-up. Quality of medical care for children with first seizure onset will be assessed and the impact of pediatric neurology clinic waiting times on seizure outcomes will be determined Methods: This retrospective study, based on chart review, includes patients with first seizure evaluation at the Royal University Hospital in Saskatoon between January 2012 and December 2015. The interim period before first assessment and other factors were studied in relation to seizure outcome on follow-up. Results: 1158 patients were assessed. 378 (32.6%) patients had first seizure clinic assessment. 197 (52%) had epileptic events. 181 (48%) had non-epileptic events. The mean age of patients was 8.8 years. The mean waiting time for assessment by a pediatric neurologist was 4.33 months. The mean duration of follow-up was 20.9 months. At the last seizure assessment, 132 patients were free of seizures and 65 patients had a recurrence of seizures. Conclusions: First seizure assessment is crucial for management of children with epilepsy. Waiting time and other factors may influence seizure outcome, representing opportunities to improve standard medical care.