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ABSTRACT In this study, we aimed to evaluate medication adherence and quality of life (QOL) in patients with hyperlipidemia. A Prospective, Randomized study was carried out in the department of general medicine for a period of 24 months in Rajiv Gandhi Institute of Medical Sciences after taking the Ethical Clearance. The patient data was collected by using a well designed questionnaire after taking their consent. The questionnaires were used to asses medication adherence via interviews, and pill and QOL was by patient report. A total of 600 patients were screened, out of which 516 patients were included in referral center group and 337 patients included in the paid clinic group. 80.4% of the total studied patients were considered to be adherence with their hypolipidemic therapies. The rates of adherence were similar between the referral center and paid clinics (78.6% vs 83.1% p=0.1). Patients who were adherence with their hypolipidemic medications also had a better health status in terms of social activities than non-adherence patients (98.1% vs 97.0%, p=0.03). This study concludes that non-adherence to medication is prevalent in the study groups but on lower side of the range, adherent patients had fewer limitations in their quality of life compared to nonadherent