Background: TB is still a significant global public health and economic issue. One of the most crucial factors in the success of TB treatment is medication adherence and health-related quality of life. Aim: assess the relationship between HRQOL and medication adherence among patients with pulmonary tuberculosis. Design & Setting: A descriptive cross-sectional study design utilized to conduct the current study in Ismailia fever hospital, Ismailia, Egypt. Sample: A purposive sample of 52 patients diagnosed with pulmonary tuberculosis. Tools: three tools were used to carry out this study. Tool I: A structured self- administrated questionnaire included two parts which involved assessment of the demographic data and patients' medical and family history. Tool II: Health Related Quality of life for patients with chronic illness. Tool III: Morisky Medication Adherence Scale. Results: According to the current study (57.7%) of the studied patients have high level of drug adherence compared to 11.5% of them had low level of drug adherence. The majority of the studied patients (88.5%) had high level of HRQOL, whereas 11.5% had low level of HRQOL. There was statistically significant positive correlation between medication adherence and total HRQOL. Conclusion: The studied patients had high level of medication adherence. Also, the majority of studied patients had high level of HRQOL. So, the current study showed that there was statistically significant positive correlation between medication adherence and total HRQOL and its domains. Recommendations: Designing and implementing an educational program about methods for improving medication adherence and HRQOL for pulmonary tuberculosis patients.