Transplantation Proceedings, v. 48, n. 7, pp. 2361-2365. Abstract Background: The relevance that adherence to treatment plays in liver transplantation, and the impact this factor may have on the success of treatment, are fundamental in assessing the variables which affect patient adherence during the pretransplantation period. Objectives: This study aims to determine factors that affect liver transplant candidates’ adherence to treatment, and analyze the association between adherence, socioeconomic and demographic factors, clinical characteristics, and patient understanding about the disease and liver transplantation. Methods: This epidemiological, observational, and prospective study included 62 patients registered in the technical database of the Universidade Federal de São Paulo during the period November 2012–May 2014. The dependent variable was adherence to treatment among liver transplantation candidates, and the independent variables included understanding the disease and the transplantation process, and depression and anxiety symptoms among liver transplantation candidates. Results: Work situation (P = .038), understanding about the disease (P = .002), and use of laxatives (P = .045) were the factors related to statistically significant adherence, and it can be concluded that implementation of an educational program may increase adherence up to 3.48 times in the pretransplantation phase, as adherence was 3.48 times lower in patients who reported little or no knowledge of the disease or the procedure.