OBJECTIVES: The methadone maintenance treatment (MMT) program has been implemented in Shanghai since 2005.  The MMT has served to provide the government departments with the necessary MMT compliance and retention data to assist in facilitating decision-making related to the development of management and intervention strategies. Our study has portrayed the trend of MMT compliance and retention and has also served to identify related predictive factors of individuals enrolled in the MMT program. METHODS: A retrospective evaluation was performed using data from the Shanghai component of the National MMT data management system (a prospectively collected database) between January 1, 2005 and December 31, 2011. The primary outcome measured was the dropout of individuals from the MMT program and defined as methadone dosing records that were missing for >30 continuous days. A cox model for recurrence events was utilized in order to estimate a hazard ratio (HR) predicting dropout rates during the follow-up period. RESULTS: A total 6169 individuals were cumulatively enrolled; 63% dropped out of the program at least once (ranging from 1 to 10 times), and 74% of them did not return until the end of this study. Our adjusted analyses demonstrated that the dropout occurring was more likely to occur among younger individuals (<30 years versus ≥50 years old, HR=1.48, 95%CI: 1.22-1.81), participants from ethnic minorities (HR=1.48, 95% CI: 1.06-2.06), those who were less educated (HR=1.31, 95%CI: 1.04-1.66), those sharing needles with others (HR=1.25, 95%CI: 1.01-1.53), those whose urine tested positive for opiates (HR=2.68, 95%CI: 2.43-2.97), and those who had a low average methadone dose in the initial treatment week (<20mg versus ≥60mg, HR=1.79, 95%CI: 1.40-2.28). CONCLUSIONS: Shanghai is facing the challenge of maintaining a high MMT retention rate. Comprehensive interventions should be considered among specific populations, such as the young, poorly educated, opiate-positive individuals and injection drug users.