Introduction: In pediatric patients, adherence is more complex as it involves factors related to children, caregivers, family regimes, society and culture (Aids info, 2014)Datafrom Amhara ,/gional HAPCO report showed that from the total HIV positive children who started ART (8440 HVC), currently there are only 5045 HIV positive children who are on ART When we see this data at Bahir Dar the total number of children who started ART were 9 21 and from which the total number of children currently who are on ART are 602 (Amhara regional HAPCO report, 2014). This showed that as there are still positive children who discontinued their ART, although Objective of this study was to assess factors contributing to ART adherence level among HIV positive children in Bahir Dar using self-response and pill count method level of adherence among HIV positive children at Bahir Dar in 5 health facility and one hospital. Result: As per the definition of adherence, in this study depending on the caregivers report 114 (82%) positive children adhere to ART In the multivariate analysis, it is the