Background: Pediatric focal epilepsy is a common neurological disorder that requires early and effective treatment to prevent long-term cognitive and psychosocial consequences. Levetiracetam (LEV) is widely used as a first-line antiseizure medication, while brivaracetam (BRV), a newer SV2A ligand with higher binding affinity, has limited comparative data in children. Aim: Our aim is to compare the effectiveness and tolerability of BRV and LEV in children with newly diagnosed focal epilepsy. Materials and Methods: This retrospective comparative study was conducted at Mount Adora Hospital, Sylhet, Bangladesh, between July 2024 and June 2025. A total of 62 children aged 1–18 years with new-onset focal epilepsy were included, with 31 receiving LEV and 31 receiving BRV. Seizure frequency and treatment response were assessed at 2 weeks, 1 month, and 3 months. Common adverse effects of both drugs were also documented. Results: After 3 months, the mean seizure frequency was significantly lower in the BRV group (0.42) compared to the LEV group (1.58; p<0.001). Complete response was achieved in 87% of BRV patients versus 61% of LEV patients (p=0.042). Both drugs were generally well tolerated. Somnolence was reported in 12.9% of LEV and 9.7% of BRV patients. Behavioral adverse effects were more frequent with BRV (hyperactivity 19.4%, irritability 12.9%) compared to LEV (hyperactivity 3.2%, no irritability). Conclusion: Brivaracetam demonstrated superior seizure control efficacy as compared to levetiracetam in children with new-onset focal epilepsy, although behavioral adverse effects were more common.