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Purpose: The purpose of this study was to compare medication adherence rates and type 2 diabetes mellitus (T2DM) health outcomes in a sample of underserved patients with suboptimally controlled T2DM (A1C >7%) who had received pharmacist-directed medication therapy management (MTM) to those who had not received MTM., Methods: A retrospective review of 100 patient records was conducted. For the MTM group, a pharmacist engaged patients in patient-centered services to optimize therapeutic outcomes. Non-MTM patients received usual care. Outcomes were A1C, medication adherence, blood pressure, lipids, and creatinine. Group comparisons on clinical outcomes were analyzed before and after matching MTM and non-MTM patients on demographic characteristics., Results: Before matching, the MTM group had a higher rate of medication adherence than the non-MTM group. The A1C levels were lower in the MTM group compared to the non-MTM group. Similarly, low-density lipoprotein (LDL) cholesterol was lower in the MTM group compared to the non-MTM group. After matching, medication adherence rate remained higher in the MTM group than the non-MTM group. Similarly, A1C levels remained lower in the MTM group than the non-MTM group., Conclusions: There is a paucity of research focused on behavioral interventions for improving health outcomes in underserved communities. Our results advance the existing literature by demonstrating a positive association between pharmacist-directed MTM, medication adherence, and glycemic control in a sample of underserved patients with suboptimally controlled T2DM. A prospective pharmacy intervention and examination of long-term effects of MTM on medication adherence and T2DM health outcomes in this population is warranted., (© 2015 The Author(s).)