OBJECTIVES: The study aimed to assess predictors of medication adherence in a hypertensive population of Pakistan. METHODS: This descriptive study was shaped as a questionnaire-based cross sectional analysis. A prevalence based sample of 385 hypertensive patients was selected from 2 tertiary care hospitals. Hypertension Fact Questionnaire (HFQ), Drug Attitude Inventory (DAI-10) and European Quality of Life scale (EQ-5D) were used for data collection. Demographic and disease related information was also taken into account. SPSS versus 16.0 was used to compute descriptive analysis of patients’ demographic and disease related information. The factors that were significantly associated with adherence were further assessed by binary logistic regression analysis. The analysis included only those parameters with p value ≤0.25 in Chi-square analysis. The power of independently related parameters and predictive models were expressed as odds ratio (OR) with 95% confidence intervals (CI). The statistical significance was set at 0.05. RESULTS: The mean age (SD) of the patients was 39.02 (6.596), with 68.8% males. The mean ± SD duration of hypertension was 3.01±0.939 years. Forty percent (n=154) had bachelor level of education with 34.8% (n=134) were working in private sector. The mean EQ-5D descriptive score was calculated 0.4674±0.28444 and EQ-Vas score 63.97±6.621. Mean knowledge and adherence scores were 8.03 ± 0.42 and -1.74 ±2.154 respectively. The created model showed a significant goodness of fit as the Omnibus Test of Model Coefficient was highly significant (Chi square = 10.983, p = 0.027, df = 4). Knowledge score had significant association (adjusted OR= 1.159, 95% CI = 1.004 – 1.339, P <0.001) with medication adherence. CONCLUSIONS: From the results of our study, it is concluded that improved knowledge towards hypertension can result in better medication adherence. Patient education must be formalized and acknowledged as an official part of the health care system.