Tuberculosis (TB) is a preventable and curable disease, but it continues to negatively impact the lives of adolescents globally. Uganda ranks among the top 30 countries in the globe with the highest burden of TB. Therefore, this study assessed determinants of adherence to Tuberculosis treatment among adolescents at selected health facilities in Adjumani District, North Western Uganda. Methods: facility based analytical Cross-sectional study design was employed with quantitative data collection approach. Binary logistics regression was used to analyze data. Results: Adherence to TB treatment was 58.92%. Being new on TB treatment (aOR=0.206; 95%CI: 0.071 - 0.597; p=0.004), treatment duration two months above (aOR=6.723; 95%CI: 1.753 -25.787; p=0.005), experience of any drug side effects (aOR=3.257; 95%CI: 1.45 -7.315; p=0.004) and poor health workers’ attitude (aOR=0.024; 95%CI: 0.001 -0.493; p=0.016). Conclusion: Adherence to TB treatment in this current study was lower than recommended 67% to 77% by TB control program and health sector report in Uganda. Health care workers need to conduct substantial counselling for TB patients with comorbidities and co-infections to help them take TB medications for the recommended six months.

Keywords: Tuberculosis, determinants, zoonosis, facilities, treatment.