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Adherence to antiepileptic drug therapy in people with epilepsy is critical for seizure control. Poor adherence to epilepsy treatment, on the other hand, is recognized as a worldwide problem, particularly in developing countries such as Ethiopia. As a result, the current study seeks to ascertain patients’ adherence to antiepileptic medications and the factors that influence it at Hawassa University Comprehensive Specialized Hospital in Southern Ethiopia. From February 1 to October 15, 2017, 187 people with epilepsy who were on followup at Hawassa University Comprehensive Specialized Hospital underwent a hospitalbased retrospective medical review. Adherence was measured using Morisky Medication Scale-8. Data was entered and analyzed using the soft ware Statistical package for social sciences version 20. The results were summarized using cross-tabulations and frequency tables. While binary logistic regression was used to analyze factors associated with adherence to antiepileptic drug therapy, significance was declared at p<0.05. According to the findings of the current study, about nineteen percent of the study participants were nonadherent to their treatment. Compared to patients with monthly income of less than 1000.00 ETB, those who earn>3000.00 ETB [AOR=0.164, 95% CI (0.038: 0.702)] and those with monthly income between 2000 and 3000 ETB [AOR=0.110, 95%CI (0.026:0.461)] [AOR=0.110, 95% CI (0.026:0.461)] are less likely associated with non-adherent to antiepileptic drugs (P<0.05). Likewise, patients who perceived epilepsy as psychiatric disorder [AOR= 0.250, 95%CI (0.087: 0.716)] compared to those who perceive it as neurologic, and those patients with seizure free period of less than one year [AOR= 0.206, 95%CI(0.076:0.562)] compared to those with seizure free period of more than one year are found to be less non adherent (p<0.05).