Objective <p>This study aimed to evaluate seizure self-efficacy and its association with perceived stigma and quality of life in children with epilepsy, integrating both child and parent perspectives.</p> Methods <p>A total of 155 children with epilepsy (aged 9–17 years) and their parents were included in this cross-sectional study. Standardized instruments were used: the Seizure Self-Efficacy Scale for Children (SSES-C), the Pediatric Quality of Life Inventory (PedsQL 4.0), and validated stigma scales for both children and parents. Sociodemographic and clinical variables (e.g., number of antiepileptic drugs, disease duration, parental education, and income) were also recorded and analyzed.</p> Results <p>Higher self-efficacy scores were significantly associated with improved quality of life and lower stigma perception in both children and parents (<i>p</i> &lt; 0.001). Multivariate regression revealed that self-efficacy positively predicted child-reported quality of life, while perceived stigma had a significant negative effect. Additional findings indicated that polytherapy, longer disease duration, lower parental education, and low household income were related to lower self-efficacy and higher stigma.</p> Conclusion <p>Seizure self-efficacy is a modifiable psychological factor strongly linked to psychosocial well-being in pediatric epilepsy. The dual-perspective approach adopted in this study provides a more comprehensive understanding of disease burden. Targeted interventions that enhance self-efficacy and reduce stigma may lead to improved quality of life outcomes for both children and their families.</p>