OBJECTIVES: To translate, validate and examine the psychometric properties of the Urdu version of the Morisky Medication Adherence Scale (MMAS) among patients with hypertension. METHODS: A systematic procedure of ‘‘forward–backward’’ was used to translate MMAS into Urdu (official language of Pakistan). It was later validated on a convenience sample of 272 established hypertensive patients between July and October 2010 visiting outpatient department of cardiac ward at Bolan Medical College Hospital, Quetta, Pakistan. For test-retest reliability, data was available for 42 patients. Internal consistency was taken as a measure to test reliability of the MMAS. Convergent and known group validity was taken into account to confirm the validity. RESULTS: The mean ± SD of MMAS score was 6.19 ± 1.81, which was measured by applying the recommended scoring method of Morisky Scale. Internal consistency was found to be moderate (Cronbach’s a = 0.621). Test–retest reliability value was 0.801 (p <0.001). By applying Spearman’s rho, positive correlation between the eight- and four item MMAS was found (r = 0.792; p <0.01). A significant relationship between MMAS categories and blood pressure control (χ2 = 20.121; p<0.001) was found. The MMAS sensitivity and specificity, with positive and negative predictive values were 71.54%, 41.48%, 44.74% and 75.56%, respectively. CONCLUSIONS: The findings of this validation study indicate that the Urdu version of the MMAS is a reliable and valid tool for the measurement of medication adherence in Pakistani health system.