Background: Despite adherence is the primary element of the effectiveness and performing lifestyle change follows agreed recommendations from a health-care provider; in developing countries, adherence of patients with chronic diseases is lower than fifty percent and without a renewed commitment to this important issue enough progress is not achieved. Thus the present study aims to assess the magnitude of medication adherence and associated factors among epileptic patients in Bahir Dar city public hospitals. Objective: To assess medication adherence and associated factors among Epileptic patients on treatment in Bahir Dar city administration public hospitals, north west Ethiopia, 2023. Methods: Institution based cross - sectional study was conducted from March 1 to 30/2023 among 396 epileptic patients. Systematic random sampling technique was carried out. Data was collected with standardized structured questionnaire and finally the data was entered using EPI- data software version 3.1 and exported to SPSS version 23 for analysis. The result was presented using tables, figures, and texts. Bivariable and Multivariable logistic regressions were conducted to obtain significant variables. Results: Adherence level to epilepsy medication was 45.5 %( 95%CI: 41%, 50%). Sex, residence, education, monthly income and occupation of participants were significantly associated with adherence to epilepsy medication in this study. Conclusion: Level of adherence to antiepileptic medications among epileptic patients in Bahir Dar City Public Hospitals was below the standard of adherence level. Hence support from different stakeholders and health professionals should focus on strong health education provision for epileptic patients and their family members in order to stay adherent to the medication intake. Key Words: Epilepsy, Medication Adherence, Bahir Dar