OBJECTIVES: To assess the barriers to treatment adherence on disease management of acromegaly from the provider prospective METHODS: A web-based cross-sectional survey was conducted from August –October, 2014.  Healthcare providers who had experience in treating acromegaly patients were asked about barriers to treatment adherence and influence on the treatment algorithm based on their experiences and perspectives.  RESULTS: A total of 23 providers (mean age: 56 years, female: 48%) completed the survey, including physicians (52%), nurses or nurse practitioners (43%) and research coordinators (5%). Most worked at academic hospitals (78%). Their specialties included endocrinology & metabolism (70%), neuroendocrinology (22%) and neurosurgery (8%). Of the providers, 62% had more than 10 years of experience (range: 5-40 years) treating acromegaly; 75% of them were concerned about the barriers to pharmacological treatment adherence. The greatest concerns were side effects (100%), financial issues (89%), and the therapy being too complicated or inconvenient to patients (56%).   Seventy percent (5 MDs and 11 nurses) had encountered patients with symptoms that became worse toward the end of an injection cycle, 80% of physicians adjusted the treatment algorithm accordingly. Of 9 nurses who had experiences with somatostatin analog (SSA) injections, 67% of them raised concerns, of which the most common were side effects (e.g., pain, erythema, hematoma), and time loss due to injections. When considering the patient’s specific needs, all physicians and nurses with SSA injection experience (n=21) would consider offering an oral therapy to patients if it had comparable efficacy and safety to the current long acting SSA treatments.  The top three determinants to drive decisions in acromegaly maintenance therapy were clinical guidelines, lower out-of-pocket cost for the patient, and lower total medical costs.  CONCLUSIONS: Study results indicated that treatment side effects, financial issues, and inconvenience were the leading barriers to treatment adherence from the healthcare provider perspective.