Adherence is a critical component of successful HIV treatment among people living with HIV/AIDS. It is essential for achieving and maintaining viral suppression, which is the primary goal of HIV care. The objective of this study was to assess the disparity of the treatment adherence of selected subpopulations among HIV adult patients in Tanzania. The study used a cross-sectional survey of 792 adults living with HIV/AIDS from 31 regions in Tanzania. A two-stage stratified cluster design was used in this survey and included jackknife replicate sampling weights. Frequency tables displaying frequencies, weighted proportions, and confidence intervals were employed to depict socio-demographic by treatment adherence. Treatment adherence was calculated as the (prescribed doses-missed doses)/ prescribed doses * 100. Rao-Scott chi-square was used to produce the weighted proportions of the adherence within subpopulations. Also, the Adjusted Wald Test was used to examine whether or not the subpopulations are similar to or different in terms of their level of treatment adherence. The results showed that there was a significant difference in treatment adherence between the selected subpopulations. The majority of the selected subpopulations, including those based on age, sex, marital status, and level of education, were found to have disparities in the level of treatment adherence. However, the study also revealed no disparities in treatment adherence between urban and rural settings, married and widowed, age groups of 25 to 34, and those of 55 and over. The study's findings revealed considerable disparities in treatment adherence between various subpopulations, emphasizing the necessity for specifically developed interventions to address these disparities so as to attain better health outcomes among adult living with HIV/AIDS.