Introduction: Adherence is a multifactorial phenomenon. Usually geriatric patients will have multiple co morbidities because of which poly pharmacy results. This can adversely affect medication compliance. The purpose of our study is to identify various factors responsible for low medication compliance. Elderly people are usually affected with chronic illnesses like Hypertension, Diabates Mellitus, Dyslipidemia, Coronary artery diseases, Osteoarthritis, etc., All these diseases require long-term treatment. So, medication compliance is a very important factor which increases therapeutic outcome., Materials and Methods: The study subjects were assessed by using 15 item structured questionnaires as per indigenously modified Morisky Medication Adherence Scale (MMAS)., Results: A total of 100 patients of geriatric age group were assessed for the level of compliance for long term medication. The compliance level was assessed by providing a 15-item structured questionnaire as per indigenously modified MMAS. The level of compliance was high in 82%, medium in 16% and low in 2% in the first visit. The level of compliance was again assessed during next review visit. The level of score during review visit was high in 74%, medium in 25% and low in 1%., Conclusion: The compliance to medication is adversely affected by complicated regimes, ignorance about the disease and complications, physical and economic problems. Geriatric patients especially have a tendency to stop taking drugs off their own when they consider their symptoms have been ameliorated. This can hinder the expected improvement in adherence in the review visit., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Family Medicine and Primary Care.)