Background: Tuberculosis affects vulnerable populations and has become a challenge for the health system. There are difficulties accessing services which create serious consequences for treatment success. Aim: To establish the relationship between the determinants of access to health services and treatment adherence in patients with tuberculosis. Methods: Correlational research with an observational cross-sectional design, in 120 patients with tuberculosis from January to July, 2019. We used the modified Tanahashi model to measure the determinants of access to health services, vand the Morisky-Green test, for treatment adherence. For the analysis, the Spearman's correlation coefficient was used with its corresponding p-value for statistical significance. Results: A total of 37.5%werenon-adherent patients and we identified a statistically significant relationship between the availability, accessibility, acceptability, contact and adherence dimensions in the bivariate analysis (Spearman's Rho: 0.694; p=0.000; Spearman's Rho: 0.744; p=0.000; Spearman's Rho: 0.607; p=0.000; Spearman's Rho: 0.693; p=0.000 respectively). Conclusions: The existence of multidimensional dynamics of treatment adherence was evidenced, which suggests the need to design and implement health policies to reduce or eliminate healthcare barriers among TB patients to achieve treatment adherence and ensure equitable and efficient access to health services.