A study conducted in the Aftit refugee camp in Ethiopia assessed the mental health and medication adherence of Sudanese refugees with chronic illnesses. Out of 231 randomly selected participants, 48.1% showed symptoms of depression, while 48.5% exhibited anxiety. Only 42% adhered to their medication regimens. Factors linked to depression included living alone, a camp stay of one year or more, food and water shortages, Khat use, and inadequate shelter. Anxiety was associated with being over 60 years old, divorced or widowed status, Khat use, and experiencing violence or torture. Higher medication adherence correlated with being over 60, having higher education, and living alone. The study highlights the need for mental health screenings in refugee care and suggests addressing structural issues such as housing and substance use to enhance mental health and medication adherence among refugees. These findings aim to inform health policies and interventions targeting high-risk groups within refugee populations.