Background: Adherence to antiretroviral therapy (ART) is a strong predictor of progression tornAIDS and death. The fact that a nearly perfect adherence is required in ART has remained arnmajor challenge to people infected with HIV. Consequently, non-adherence to the proposedrnantiretroviral regimen is considered to be one of the greatest dangers to the response to treatmentrnon an individual level and the dissemination of resistant viruses on the community level.rnObjectives: - The aim of the study was to identify the adherence level and associated factorsrnwith adherence to ART among HIV infected children aged 2- 14 years in Black Lion SpecializedrnHospital ART clinic, Addis Ababa, Ethiopia.rnMethod: - A cross-sectional study was conducted between April and May, 2015 in TikurrnAnbessa Specialized Hospital, Addis Ababa, Ethiopia. A total of 190 children aged 2-14 years onrnfirst line ARV regimen for at least six month were included in the study. The registered list of thernchildren on ART by unique ART registration number was used as sampling frame. Data wasrncollected by using interview with structured questionnaire. Ethical clearance was secured fromrnAddis Ababa University College of health sciences institutional ethical review board. Therncollected data was cleaned, checked for quality, coded and analyzed by using manual andrnstatistical methods, logistic regressions were computed. Odds ratios were computed to determinernthe level of significance.rnResult: A total of 190 children were included in this study, and 89.8% of the participants hadrntaken their prescribed ARV drugs fully for the past 7 days. Considering individuals who had everrnmissed their dose regardless of time reference, overall adherence rate 87.75% was obtained.rnAlthough most frequently mentioned reason of missing their dose in the last one week wasrnforgetting (48.1%), ADRs, Quarrel among family are also found to be barriers to adherence.rnAfter controlling the effects of other variables, two variables namely income and occupation werernfound to be significantly associated with adherence to ART in children.rnConclusion: Adherence rate obtained in this study is lower than what is required. Forgetfulness,rnADRs, and quarrel among family were most frequently mentioned barriers of adherence.rnIncome and occupation are factors found to be significantly associated with adherence to ART inrnchildren