Background: non-adherence to medication is considered as one of the largest drug related issues in the medical field. It results in development of drug resistance besides other harmful effects on the health of individuals. Aim of the work: there is very little data about compliance in Saudi Arabia. So, we conducted this study to see the adherence to the antibiotics by the patients in Al-Ahsa comparing the urban and rural population. Methods: this was a cross sectional observational study in which 215 people were asked questions about the adherence to the antibiotics prescribed by physicians. A convenient sample of 215 people was selected due to the constraint of resources (Finance and time). A questionnaire was designed to include the questions about the adherence to the antibiotics prescribed besides demographic characteristics. Data were entered in SPSS statistic20 which was also used for analysis by using crosstab for the numeric data and chi-square was used to see if there was a relationship between variables. Results: the present results showed that 70.69% of the population was not adhering and 29.30% were adhering to the antibiotic course. In urban population, 38% of the people were adhering to the short term antibiotics compared to 22% in rural areas. Conclusion: there is a need for increasing the awareness about completing the antibiotic course among the people in general and in rural areas in particular.