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This study investigated factors influencing adherence to TB treatment among adult tuberculosis patients at Annalena hospital in Borama district. A factor is any condition that may influence the state of something and cause it to assume a new and relatively permanent form. TB has been known to mankind since ancient times, as an infectious disease that spreads through the air from person to person as infectious droplets. The problem of the study was poor adherence to TB treatment and reported 1557 people infected TB in Awdal Region in 2015- 2017, but only 15.6% of the suspected cases were reported and registered for treatment. The rest 84.4% were not likely to get treatment or could start treatment late and are reported poor adherence to TB treatment. The study focused on three objectives: were to determine the accessibility, stigma and socio-economic status on adherence to TB treatment among adult tuberculosis patients at Annalena hospital in Borama District.