Background: COPD is characterised by persistent airway obstruction in which better clinical outcome can be attained by appropriate management of disease. Adherence to COPD medication is poorly understood due to chronic nature of the disease. It is crucial to identify the barriers of non-adherence to build up and execute policies and interventions to upgrade medication adherence. Objective: To identify the predisposing barriers of medication adherence and to find the association between medication adherence and variables. Methods: A descriptive analytical study was conducted and data was collected from COPD outpatients. The Morisky Medication Adherence Scale was used to measure adherence and self-assessed questionnaire was employed to identify the predictors of poor adherence. Chi square test was carried out to find the relationship between medication adherence and variables such as age, gender, literacy, socioeconomic class, polypharmacy, delivery device and climate. Results: A total of 403 patients were involved in the study where 68% reported lower adherence. The most common adherence barriers found were forgetfulness (88%), intentional stoppage of medicines when symptoms improve (83%) and negligence towards medication (82%).A significant association was found between gender, literacy, socioeconomic class, polypharmacy, delivery device and climate. Conclusion: Adherence to medication regimen in COPD patients is poor, even though it is a preventable and a treatable disease. Well-structured education, training, counseling is required to overcome medication adherence particularly among illiterate and low socioeconomic class patients. The combined interventions should be used such as video clips demonstrations of inhaler technique should be given. Keywords: COPD, Morisky medication adherence scale, Chi square test.