BACKGROUND:Many patients with schizophrenia have impaired insight and low medication adherence. Poor adherence is one of the leading problems affecting the effectiveness of treatment in schizophrenia. It is an identified factor for relapse and hospitalizations with major social and economic consequences. OBJECTIVE:The aim of this study was to study the relation between insight and medication adherence and other factors that may affect both of them. SUBJECT AND METHODS:A total number of 50 schizophrenic outpatients “DSM 5" aged > 18 years old who were attending the hospital for regular follow up were included in this study. From the selected patients full medical history was obtained including: name, age, gender, occupation, educational status, history of the psychiatric disease, duration, medical treatment and times of hospitalization. Cultural and social standard and degree of family support was also collected. Patients' insight was measured by the Schedule for Assessment of Insight-Expanded Version (SAI–E) translated into Arabic by Marwa Abdelgawad. The degree of medication adherence was measured by using Medication Adherence Rating Scale (MARS). RESULTS:There was no significant correlation between patients' insight and patients' ages, duration of illness and hospitalization times with p-value: 0.69, 0.61 and 0.07 respectively. In addition, there was no significant association between medication adherence and age, duration of illness, number of hospitalization, gender, social level and family support with p-value: 0.575, 0.678, 0.566, 0.945, 0.091 and 0.360 respectively. Our results showed a strong positive correlation between insight and medication adherence with p-value: < 0.0001. CONCLUSION: Insight and adherence were found to be closely related, low insight was associated with poor adherence in patients with schizophrenia. Moreover, these results should be used to establish a strategy for improving the prognosis of chronic schizophrenia.