Abstract: Objective: To explore the current status and influencing factors of Immunosuppressive Medications adherence in older kidney transplant recipients. Methods: Totally 92 older kidney transplant recipients were recruited in the outpatient department in a tertiary Grade A hospital by convenience sampling method and investigated with the Demographic Questionnaire, Basel Assessment of Adherence with Immunosuppressive Medication Scale, Self-rating Depression Scale, Perceived Social Support Scale, Perceived Health of Control Scale, and Symptom Checklist. We analyzed the influencing factors of medication adherence among older kidney transplant recipients by logistic regression analysis.Results: The adherence rate was 58.70%. Logistic regression analysis showed that gender [OR=0.333, 95% CI (0.131, 0.850),P=0.021], perceived health of control [OR=0.878, 95% CI (0.772, 0.998), P=0.046] and perceived social support [OR=0.961,95% CI (0.972, 0.996), P=0.028] were influencing factors of medication adherence among older kidney transplant recipients.Conclusion: The medication adherence among older kidney transplant recipients is poor. Perceived health of control and perceived social support are predictors of medication adherence among older kidney transplant recipients.