Background: TRAMADOL is a widely prescribed analgesic and due to its opioid-like effects, the potential for abuse of TRAMADOL is noticeable. Besides, the complications of TRAMADOL abuse have become a public health concern. This study aimed to investigate the affecting factors on the seizure, as one of the most common complications of TRAMADOL consumption. Methods: A total number of 64 patients from 315 patients who were referred to Sina Hospital, Tabriz, Iran because of TRAMADOL toxicity were included in this 9 months cross-sectional retrospective study. Results: There were 52 males and 12 females in the study. The seizure happened in 53. 1% of the subjects and the Mean± SD time between TRAMADOL consumption and seizure was 5. 9± 7. 36 hours. There was no significant association between seizure and sex, age, the dose of TRAMADOL, and previous TRAMADOL consumption history. A significant association was seen between the dose of TRAMADOL and the time of seizure. Conclusion: Seizure that happens due to TRAMADOL overdose is not dependent on sex, age, and previous history of TRAMADOL consumption. As the dose of TRAMADOL is higher, the seizure happens later. More research is needed to understand why the seizure occurs later in higher doses.