Introduction: About 127,000 adolescents aged 10 to 19 are living with HIV in Uganda (UNAIDS, 2013). Both good adherence and retention in care are a prerequisite to successful management of adolescents living with HIV (ALHIV). Poor adherence is associated with poor treatment outcome (UNICEF, 2017). In the case of ART, optimal adherence is taking 95 % and above of prescribed medication (Gokarm et al., 2012). However in a study carried out in among adolescents attending Kalisizo Hospital, Kyotera District in July 2018 adherence was found to be low, thus a need for this study. This study aimed to assess the factors associated with adherence to antiretroviral treatment among adolescents attending Kalisizo Hospital, Kyotera District in July 2018. This was based on study specific objectives that included; assessing the individual, drug related and health care related factors associated with adherence to antiretroviral treatment among adolscents attending Kaliisizo Hospital Kyotera District. Methodology: The study used a descriptive cross-sectional design where a sample of 355 respondents who were adolescents between 10 and 25 on antiretroviral treatment was used. Stratified and simple random sampling techniques were used to select the respondents and data was collected using self-administered questionnaires and analyzed using SPSS. Results: The level of adherence to antiretroviral treatment was low at 33%. This was far lower than the national target of 90%. This was attributed to individual, drug and healthcare factors.Individual factors were; gender (χ2 = 59.13 P=0.001), age (χ2 = 9.74 P=0.021), marital status (χ2 = 8.10 P=0.044), Education (χ2 = 12.88 P=0.005), place of residence (χ2 = 50.94 P=0.001), family size (χ2 = 11.02, P=0.012) and religion (χ2 = 12.68, P=0.027). Drug related factors included; having all the drugs they were supposed to take (χ2 = 18.58, P=0.001), challenges faced with the drugs (χ2 = 19.16, P=0.001), Frequency of taking ARV pills in a day (χ2 = 4.06, P=0.044), challenges faced when taking ARVs (χ2 = 5.28, P=0.022) and accessibility to ARV drugs (χ2 = 4.27, P=0.039). Health related factors were; getting routine education and counseling about adherence to ARVs (χ2 = 71.63, P=0.001), source of information (χ2 = 62.03, P=0.001), had nearby health care facility to pick ARV drugs (χ2 = 68.70, P=0.001), Distance between health facility and respondents home (χ2 = 45.45, P=0.001), availability of ARV on appointment day (χ2 = 14.60, P=0.001), availability of health care workers for ARV services (χ2 = 31.41, P=0.001), How often have you been coming for ARVs refill at the clinic (χ2 = 60.25, P=0.001) and waiting time on the appointment day to pick the drugs(χ2 = 75.71, P=0.011). Conclusion: The level of adherence to antiretroviral treatment was low. This was attributed to missing of taking of drugs due stigma, drug stock outs, failure to get routine education about ART, distance to health facility, inadequacy of information given and long waiting time

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