Tuberculosis (TB) remains a major global public health problem, with treatment success highly dependent on patients’ adherence to anti-tuberculosis drugs (OAT). Non-compliance may lead to treatment failure, increased transmission, and the development of drug-resistant TB. Several factors are known to influence medication adherence, including education level, knowledge, and support from healthcare workers. Objective: This study aimed to review and synthesize evidence on factors influencing compliance with taking anti-tuberculosis drugs, focusing on education level, knowledge, and healthcare worker support. This study employed a literature review design. Articles were retrieved from ScienceDirect and Google Scholar databases and selected based on predefined inclusion and exclusion criteria. Inclusion criteria were open-access full-text articles published between 2021 and 2025 that discussed adherence to OAT treatment and related factors. A total of fourteen relevant articles were included in the review. The review findings showed that patients’ knowledge and support from healthcare workers were the most consistently associated factors with medication adherence. Higher levels of knowledge were linked to better compliance with treatment regimens. Support from healthcare workers, including counseling, supervision, and motivation, played a critical role in improving adherence. The level of education demonstrated an indirect influence, as higher education facilitated understanding but did not independently guarantee compliance. Knowledge and healthcare worker support are key determinants of adherence to anti-tuberculosis drug treatment. Strengthening patient education and optimizing the role of healthcare workers are essential strategies to improve treatment compliance and prevent drug resistance.