Introduction:- Diabetes mellitus is a chronic progressive disease characterized by numerous health complications. Medication adherence is an important determinant of therapeutic outcome. Oral hypoglycemic agents (OHAs) are the major treatment for people with type 2 diabetes mellitus (DM2). However, non-adherence to OHAs remains are one of the main reasons for poor glycemic control. Medication nonadherence in patients with chronic diseases, particularly in type 2 diabetes mellitus (T2DM) with comorbidity, has continued to be the cause of treatment failure. The current study assessed the level of medication adherence in T2DM patients with and without Hypertension. Methods:- A total of 350 patients were enrolled from the Department of Internal Medicine at King George's Medical University ( KGMU), Lucknow according to the American Diabetes Association (ADA) guidelines. Both male and female patients of age between 35-75 years , on oral hypoglycemic agents (OHA) , excluding insulin , providing written consent were included in the study. An institutional-based descriptive cross-sectional study was conducted among T2DM patients. The seven item Morisky Medication Adherence Scale questionaire was used to assess the level of adherence. The questionaire had 7 questions with 4 responses each and a 4 point Likert scale was used for each questions .The response “never” will be given a score of 4 , “sometimes” ( one to four times per month ) score of 3 , “often” ( more than five times per month ) score of 2 and “always” a score of 1. According to the scoring it was further divided into low , medium and high adherent. On each visit to the OPD the questionaire was provided to the patients. Results:- A total of 60 patients were lost to follow-up, resulting in 290 patients having diabetes further completed the study. About 10.7% had a high adherence, 34.5% had a medium adherence, and 54.8% had a low adherence level respectively. Adherence score level was positively and significantly correlated with age (P< 0.05). Similarly significant correlation was found between adherence level with gender (P< 0.05). However adherence level was not significantly associated with duration of diabetes (P>0.05) and number of hypoglycemic medications (P>0.05). A logistic regression model was used to identify predictors of the level of medication adherence and glycemic control. P < 0.05 at 95% confidence interval (CI) was statistically significant. Conclusion:- The majority of patients having diabetes in this study had low adherence level. The three main factors which contributed to non-adherence to medication are non-adherence to regular follow-up visit in diabetes OPD , non-adherence to healthy diet, and non-adherence of instructions on taking medication. The current study concluded that medication adherence was low and significantly associatedwith poor glycemic control. Number of medical conditions and medications were foundto be associated with medication adherence. Management interventions of T2DM patientswith comorbidity should focus on the improvement of medication adherence.