Objective To explore the influence factors of recurrence after a first unprovoked seizure in adults within 1 year. Methods One hundred fifty-nine adult patients with first unprovoked seizure were recruited in the study. Patients were then divided into the relapse group (n=54) and the relapse group (n=105). Statistic analysis was performed on the clinical data including gender, age, history of traumatic brain injury, electroencephalogram (EEG) and brain imaging, the form of attack time, seizures, diabetes mellitus, hypertension, coronary heart disease, hyperlipidemia disease. Results Multiariable Logistic regression analysis found that history of brain injury (P=0.033, OR=5.547), period (P=0.001, OR=33.660) in the evening, cortical lesions (P=0.004, OR=14.865) were independent risk factors for recurrence. Conclusions Adult patients with first unprovoked seizure have a high risk of one-year recurrence if the patients have a history of traumatic brain injury, the radiographic abnormalities, cortical lesions and sleep attacks.