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Medication adherence has become a major concern in methadone maintenance treatment (MMT) worldwide, but little is known about this in Vietnam. This study aimed to identify adherence level among outpatients at district clinics in Vietnam. A cross-sectional study of 450 MMT outpatients was conducted at three clinics in Ho Chi Minh City (HCMC). Participants underwent face-to-face interviews using a structured questionnaire. Adherence was measured based on both the number of doses missed under Vietnam Ministry of Health criteria and the lev