Tramadol is a centrally acting analgesic agent with mureceptor agonist and serotonin and noradrenalin reuptake inhibitor effects. Tramadol is generally a well tolerated drug with few transient side effects. One of the rare but potentially dangerous side effects of tramadol is seizures. In human and animal studies tramadol has been shown to cause seizures in high doses. In therapeutic doses, it is suggested that tramadol alone is not a high risk factor for developing seizures, but becomes a highly potential risk factor in presence of additional precipitating factors. In this case report, a case with severe back pain who had been treated with parenteral tramadol and subsequently developed recurrent seizures and agitation is presented. Absence of any other concomitant drug use, exclusion of all other possible etiological factors, and normal EEG make us to think that seizures were directly linked to parenteral tramadol use. Tramadol can cause prominent side effects like seziures even in therapeutic doses. Besides, the precipitating factors for the development of seizures after tramadol use such as a history of epileptic disorder or isolated seziures and concomitant use of several drugs lowering the epilepsy threshold should be taken into account while prescribing this drug as they are of vital importance to the patients.