Background: Breast cancer is one of leading cause of morbidity and mortality in Ethiopia.rnAdjuvant hormonal therapy (AHT) is one of the treatment modality given for a patient withrnbreast cancer with estrogen receptor positive after primary treatment for 5-10 years. Nonadherencerntornadjuvantrnhormonerntherapyrninrnbreastrncancerrnsurvivorsrnisrncommonrnandrnassociatedrnrnwithrnincreasedrnriskrnofrnrecurrencernofrncancer,rninvadernthernotherrnbreast,rnandrnconsequentlyrnincreasernrnmorbidityrnandrnmortality.rnrnrnrnObjective:rnTornassessrnlevelrnofrnadherencerntornadjuvantrnhormonalrntherapyrnandrnassociatedrnfactorsrnrnamongrnrnwomen with breast cancer who attends oncology outpatient at Tikur AnbessarnSpecialized Hospital. rnMethod: Institutional based cross-sectional study was conducted. Convenience samplingrntechnique was used to select 216 participants. A semi-structured questionnaire was used afterrnsome modifications and Morisky Medication Adherence Scale (MMAS-8). Data were enteredrnin EpiData version 4.4.2.1 and exported to SPSS version 24, and analyzed using ordinal logisticrnregression with OR and 95%CI. rnResult: Out of 216, 209 women with breast cancer participated in the study with response raternof 97%. The level of adherence was 41%, 33%, and 26% for low, medium and high adherencernrespectively. Age group 65 with (OR= 2.6,rnCI (3.8-7.6) p-value 0.001); being from urban (OR= 1.5, CI (1.1-2.8, p-value 0.001); being onrntamoxifen (OR= 1.6, CI (0.4-2.2), p-value 0.005); having side effect (OR= 1.5, CI (0.4-1.9), pvaluernrn0.004); comorbidity (OR= 1.6, CI (1.5-3.4, p-value 0.001) and Getting a thoroughrntherapeutic communication (OR= 1.7, CI (1.2-3.2), p-value 0.001) were found to bernsignificantly associated with adherence to AHT. rnConclusions and recommendations: In summary, the high adherence level to AHT amongrnwomen with breast cancer was 26% in Tikur Anbessa Specialized Hospital. Age, place ofrnresidence, types of AHT, side effect, comorbidity, therapeutic communication from health carernproviders were significantly associated with adherence. Healthcare provider should give healthrneducation concerning medication usage, management of side effects and should also give duernattention to rural patient.