Topiramate, an anti-epileptic drug, is also used for migraine prophylaxis. A patient presented with symptoms of light-headedness and palpitations due to sinus bradycardia while being up-titrated on topiramate. This association scored a ‘probable’ on the Naranjo adverse drug reaction probability scale. This case report highlights this rarely reported adverse effect of topiramate and the importance of ruling out medications as a cause of bradycardia.