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Introduction. Medication non-adherence is a global concern, particularly in the context of kidney transplantation, where it leads to graft failures, increased hospitalizations, a reduced quality of life for patients, and higher healthcare costs. The aim of this study was to assess the level of therapeutic adherence among Algerian kidney transplant recipients and identify potential influencing factors. Methods. A descriptive, cross-sectional bicenter study was conducted among kidney transplant patients receiving outpatient care at two specialized medical centers in Algeria: the urology department of the Medical Center for Urology, Nephrology, and Kidney Transplantation in Constantine, and the nephrology and kidney transplantation department of the University Hospital Center (CHU) in Blida, spanning from January to December 2022. Therapeutic adherence was assessed using the 8-item Morisky questionnaire, while the level of knowledge was analyzed using a 12-item questionnaire. Logistic regression was used to identify factors associated with non-adherence to therapy. Results. This study included 130 patients with an average age of 47 and a sex ratio of 1.7. The results revealed therapeutic non-adherence in 40.8% of the patients. Multivariate analysis identified several potentially associated factors, including residence, unemployment status, lack of affiliation with a health insurance fund, the use of a therapeutic regimen involving triple therapy, the occurrence of adverse effects, limited education level, and insufficient disease knowledge. Furthermore, non-adherence was associated with an increased risk of graft rejection. Conclusion. The findings of this study highlight concerning therapeutic adherence among kidney transplant recipients, emphasizing the crucial importance of therapeutic education to improve treatment adherence and highlighting the need to integrate these factors into clinical patient management.