Objective: This study aims to explore the barriers to patient awareness and compliance with warfarin therapy among mechanical valve replacement patients.Methods: Employing a cross-sectional design, the study engaged 164 patients from cardiac outpatient during AugustOctober 2022 at Department of CVTS, T.N. Medical college and BYL Nair Ch. Hospital, Mumbai. Patients takenwho were on long-term warfarin therapy following mechanical valve replacement. Data collection involved structured questionnaires assessing patients' awareness and compliance with warfarin therapy. Statistical analyses, including multiple regression and correlation, were applied to identify factors influencing medication compliance.Results: In this study involving 164 participants. The study identified significant associations between demographic factors (age, gender, education level, employment status), clinical factors (type of valve replacement, duration of warfarin treatment), and compliance with warfarin therapy. Logistic regression analysis revealed that age, gender, education level, employment status, type of valve replacement, duration of warfarin treatment, awareness of PT-INR, experience of adverse events, and receipt of counseling significantly influenced therapy compliance.Discussion: The study's findings emphasize the importance of warfarin knowledge in enhancing medication adherence among mechanical valve replacement patients, while also highlighting the need for comprehensive support that addresses both psychological factors and demographic and clinical characteristics.Conclusion: The study highlights the need for personalized patient education and support to boost compliance with warfarin therapy in individuals with mechanical valve replacements. Customized interventions tailored to each patient's characteristics and requirements can improve treatment adherence and enhance patient outcomes. Further investigation is needed to explore other factors affecting therapy compliance and to devise effective strategies for encouraging adherence to warfarin therapy in this specific patient group.