The study aims to determine the adherence to anti-hypertensive agents as well as the factors influencing adherence levels among patients undergoing haemodialysis in Hospital Raja Perempuan Zainab II (HRPZ II), Kelantan, Malaysia. A total of 82 patients were enrolled in this study. A convenience sampling was done based on the number of haemodialysis patients registered in the study centre (Haemodialysis Unit, HRPZ II, Kelantan, Malaysia) who were also on anti-hypertensives. A validated Medication Compliance Questionnaire which consisted of ten questions gauging drug-taking and drug-stopping behaviours among Malaysian hypertensive patients was used to measure adherence. The majority (84.1%) of patients adhere to their anti-hypertensives. Despite this fact, only 42.7% of the patients achieved the target blood pressure (BP) control. A multiple logistic regressions analysis showed that uncontrolled diastolic BP [adjusted odds ratio (OR) = 0.928 (95% CI: 0.873 – 0.987); p = 0.018] and cigarette smoking [adjusted OR = 11.62 (95% CI: 1.55 – 86.99); p = 0.017] were independent factors for non-adherence to anti-hypertensives in this study indicating that patient’s education and support may be necessary. Although a good adherence to anti-hypertensives were observed among haemodialysis patients, BP control remains poor due to poor control of diastolic BP and cigarette smoking.