Diabetes Mellitus (DM) is a metabolic illness that causes excessive blood sugar levels as a result of either impaired pancreatic insulin production, insulin resistance, or both. People with diabetes mellitus die prematurely, and DM is a global burden. Adherence to drug regimens is essential in the management of diabetes mellitus, in addition to lifestyle changes. However, patients with diabetes are more likely not to take their medications as prescribed, and poor medication compliance jeopardizes patient safety and treatment efficacy, increasing mortality and morbidity. This study aimed to determine oral diabetes medication adherence and its associated factors among type two diabetes patients (T2DM) at Jinja Regional Referral Hospital. An institutional-based cross-sectional study of 136 T2DM patients was undertaken at Jinja Regional Referral Hospital in Jinja district. A convenience sampling technique was used to recruit participants, and the research was carried out from April 2022 to October 2022. The Morisky Medication Adherence Scale was used to assess medication adherence. STATA version 15.1 was used to analyze the data. To discover independent determinants of T2DM adherence, logistic regressions were used. To declare statistical significance, a P-value of less than 0.05 was employed. This study enrolled 136 type 2 diabetes patients, with a response rate of 100%. Overall, 58.33% of T2DM patients showed good medication adherence. T2DM patients who took both oraland injectable anti-diabetic medications (AOR = 1.98, 95% CI: 1.16-3.39), received the prescribedanti-diabetic medication from the hospital (AOR = 0.51, 95% CI: 0.32-0.80), had their own glucometer at home (AOR = 0.30, 95% CI: 0.16-0.54), and had good diabetes-related knowledgewere found to be more adherent to oral antidiabetic medication. At Jinja Regional Referral Hospital, there is a low prevalence of oral anti-diabetic drug adherence among patients with T2DM. Significant independent predictors of anti-diabetic treatment adherence included the type of medication that T2DM patients were taking, the ability of patients to receive their prescriptions from the hospital, having a glucometer at home for glucose monitoring, and having sound knowledge of diabetes. Patients should therefore receive more education on the importance of medication adherence, and as well be encouraged to purchase personal glucometers. Keywords: Diabetes Mellitus, Blood sugar levels, Insulin, Medication adherence, Oral antidiabetic.