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Mongolia has the highest mortality rate due to hemorrhagic stroke in the world. In addition, previous national STEPS survey results indicate very low control rate of hypertension. Nearly 70 percent of all hypertensive people were non-adherent to medication in recent hospital-based study. In current study, we aimed to assess the medical adherence in hypertensive people who are randomly sampled from Mongolian population.Between December 2017 and January 2018, a prevalence study of hypertension was conducted in Ulaanbaatar, Mongolia. 4622 participants were enrolled. Out of these participants, 485 hypertensive people who fulfilled the following criteria were enrolled in this study. Criteria to enroll was defined as BP ≥140 and/or ≥90 mmHg or being on drug therapy (for the past two weeks) and responded to each question about medical adherence. We used the Hill-Bone Compliance scale with 14 items to assess the medical adherence in hypertensive people. Each item was assessed using a four-point Likert scale (1 = none of the time, 2 = some of the time, 3 = most of the time, and 4 = all of the time). Then we classified responses into two groups of perfect compliance (who response with 4 point) and imperfect compliance (who responses with 1–3 points).Overall 485 participants were included in this study and 169 (34.85%) was male and mean age was 55.59 ± 12.09. Mean systolic and diastolic blood pressure was 140.21 ± 20.68 and 87.82 ± 13.23, respectively. The mean total score of Hill Bone Compliance Scale was 24.39 ± 4.8 (Table1).Almost half of hypertensive people was poorly adherent to medication in Ulaanbaatar, Mongolia by Hill-Bone Compliance Scale. Adherence to anti-hypertension medication needs to be improved in Ulaanbaatar for hypertensive patients.