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The study found that, coverage of ivermectin was at 51%, (213/420) in the last MDA cycle. Out of the 278 individuals who at least took ivermectin in the last three distribution rounds, only 14% (39/278) respondents are high compliers and 26.6% (74/278). Those who do not feel at risk were less likely to comply compared to those who feel at risk (OR 0.39, 95% CI 0.21-0.74). Those who have knowledge on signs and symptoms are more likely to comply compared to those without knowledge (OR (1.91, 95% CI 03-3.56). Those who were advised were more likely to comply compared to those who were not (OR 0.47 95% CI 0.24- 0.92). The study found that attitude towards ivermectin uptake is still poor and this is because people claim medicine makes them weak and some do not consider the disease as a big threat to their life. Compliance to ivermectin treatment was low in Gulu district. Members of the community within Gulu district needs to health educated and be sufficiently mobilized to appreciate onchocerciaisis as a health problem so as to positively change their perception towards treatment using ivermectin to control onchocerciaisis.