Abstract: Objectives: To investigate the current status and associated factors of medication compliance in the elderly with polypharmacy. Methods: Convenient sampling was used to recruit 178 elderly patients with polypharmacy who were hospitalized in a tertiary hospital. Using self-developed general information questionnaire, self-developed medication knowledge questionnaire, and Morisky questionnaire to evaluate medication compliance. Results: The rate of medication compliance in the elderly with polyphamacy was 25.8%. Multivariate analysis showed that age (β=-1.061) and types of drugs (β=-0.169) had negative effects on the drug compliance, and the knowledge level of the drug (β=0.059) had positive effects on the compliance of the drug. Conclusion: The study showed that the medication compliance of elder was lower. To improve the medication compliance of elder with polyphamacy, medical staff should strengthen medication guidance, drug treatment follow-up by a team of clinical doctors, nurses and pharmacists and reduce the types of drugs.