Ensuring adherence to chemotherapy is important to prevent disease progression, prolong survival andsustain good quality of life. Capecitabine is a complex chemotherapeutic agent with many side effects that mightaffect patient adherence to treatment. This cross sectional study aimed to determine adherence to capecitabineand its contributing factors among cancer outpatients in Malaysia. One hundred and thirteen patients onsingle regime capecitabine were recruited from Hospital Sultan Ismail and Hospital Kuala Lumpur fromOctober 2013 to March 2014. Adherence was determined based on adherence score using validated MedicationCompliance Questionnaire. Patient socio-demographics, disease, and treatment characteristics were obtainedfrom medical records. Satisfaction score was measured using the validated Patient Satisfaction with Healthcarequestionnaire. The mean adherence score was 96.1% (standard deviation: 3.29%). The significant contributingfactors of adherence to capecitabine were Malay ethnicity [β=1.3; 95% confidence interval (CI): 0.21, 2.43; pvalue=0.020], being female [β=1.8; 95%CI: 0.61, 2.99; p value=0.003]), satisfaction score [β=0.08; 95%CI: 0.06,1.46; p value=0.035], presence of nausea or vomiting [β=2.3; 95%CI: 1.12, 3.48; p value <0.001] and other sideeffects [β=1.45; 95%CI: 0.24, 2.65; p value=0.019]. Adherence to capecitabine was generally high in our localpopulation. Attention should be given to non-Malay males and patients having nausea, vomiting or other sideeffects. Sufficient information, proactive assessment and appropriate management of side effects would improvepatient satisfaction and thus create motivation to adhere to treatment plans.