Background of the study: Tuberculosis is curable and preventable as long as the infected patients take their medication as prescribed without interruption and all preventive measures observed both within the hospital and the community. Adherence to tuberculosis treatment by tuberculosis patients is key to the global control of tuberculosis. Methods: This cross sectional study was carried out at the Mile-4 hospital, a tuberculosis treatment center in Abakaliki, Ebonyi State, Nigeria. A total of 125 tuberculosis patients were recruited for the study and self-administered questionnaires and focus group discussions were used to get responses from the patients. Descriptive and inferential statistics with the aid of SPSS version 20 was used for data analysis. Results: Major reasons given for missing appointment and not following treatment schedule closely were lack of money, long distance from health facility, inadequate health education and non provision of food. Lack of money and long distance from health facility accounted for 60.9% of the reasons for not adhering to the treatment schedule by the tuberculosis patients. Conclusion: Adherence to tuberculosis treatment can be facilitated by extensive health education, minimal financial support and provision of food to tuberculosis patients. Distance from health facilities is also very important in the adherence to anti tuberculosis therapy by tuberculosis patients.