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Introduction: Non-adherence to antipsychotic medication is a key factor to poor treatment outcome, frequent relapse, poor quality of life and increased economic burden of mental illness., Objective: To determine the prevalence and associated factors of medication adherence among patients with schizophrenia on antipsychotic medications., Methodology: Through a cross-sectional survey, two hundred and nine patients with schizophrenia on antipsychotic medications were recruited through a systematic random sampling to participate in the study. Data were collected using the Socio-demographic Questionnaire, Medication Adherence Rating Scale and Positive and Negative Symptoms Scale. Frequencies and percentages were used to compute categorical variables. Associations of socio-clinical variables with medication adherence were analyzed using chi-square and variables with significant association were subjected to logistic regression analysis to determine the independent predictor of medication adherence., Result: The prevalence of high, medium, and low medication adherence was 43.1%, 44%, and 12.9% respectively. Factors significantly associated with medication adherence at bivariate analysis were age (χ2=22.97; p=0.003), number of drugs (χ2=16.23; p=0.003), female gender (χ2=6.55; p=0.038), prolactin level ((χ2=14.93; p=0.021) and severity of illness (χ2=17.77; p=0.007). The independent predictors of high medication adherence were age (p=0.014), fewer number of drugs (p=0.006), and normal to mildly ill on PANSS scale (p=0.015)., Conclusion: Non-adherence to antipsychotic medication was found among 56.9% of patients with schizophrenia. The findings of this study call for a proactive psychosocial counselling approach for mental health consumers and their caregivers., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2023 by West African Journal of Medicine.)