Objective: To evaluate medication adherence and analyse the prescribing pattern of cardiovascular disease patients in tertiary care hospital using a newly developed medication adherence scale. Methods: It is a multi centered retro prospective observational study, conducted for a period of 6 months involving around 300 cardiac patients. The level of adherence is measured using newly developed medication adherence scale and prescribing patterns in cardiovascular patients is assessed through case reports. Analysis of data was done. Results: Among 300 cardiovascular patients, 58% were male and 42% were female. Most commonly diagnosed diseases are ST segment elevated myocardial infraction (28.3%) and left ventricular dysfunction (14%). Drugs used for the treatments are aspirin (95%) and clopidogrel (85.6%). Major risk factor is alcohol (11.6%) consumption, Hypertension and Diabetes Mellitus (9.6%). Major indication of cardiac patients is chest pain (42%), nausea (41%).The diagnosis was performed using Echocardiogram (89%), 2D-Echo (52%). The maximum adherence is seen in the age group of 31-40 female and male. Age group of 51-60 are more non adherent compared to other groups in males, whereas in females age group of 61-70 are more non adherent. Overall study show that Females (62%) are more non adherent compared to males (58.6%). The major reason for reduction of medication adherence is long duration regimens, lack of clinical communication between patients and health care professionals, forgetfulness etc. Conclusion: According to the study there is a suboptimal adherence is seen in cardiac patients and requires clinical interventions, which include affordable medications, easy-to-use medication regimens with fewer daily doses, communication between patients and healthcare providers