Non-Communicable Diseases (NCDs) are the primary global cause of death, with profound negative effects on individuals, families, communities, and healthcare systems. The escalating burden of chronic illnesses, particularly in low and middle-income countries, necessitates effective disease management. This study investigates barriers to medical service access and adherence to prescribed regimens for NCD patients attending Divisional Hospital Thalangama's NCD clinics. Conducted through a descriptive cross-sectional approach, the study engaged 400 participants via random sampling. Data collection employed a pre-tested questionnaire with five sections, and analysis featured descriptive and inferential statistics, including Chi-Square tests using SPSS version 25 and Microsoft Excel. Ethical clearance and permissions were obtained from relevant authorities.Demographic findings reveal a sample primarily composed of married, Buddhist, Sinhalese females (56%), with a mean age of 63.0 ± 10 years and income of 34,462.65 ± 16,496.7 LKR. A majority had primary education (73.5%) and was unemployed (53%). Notably, most refrained from alcohol (75.5%) and smoking (81.25%).Prevalent NCDs were diabetes type-II (69.3%), hyperlipidemia (79.3%), and hypertension (84.3%), with average disease durations of 9.16 ± 6.29 years for hypertension and 9.7 ± 7.13 years for diabetes type-II. Key prescribed drug groups included Angiotensin II receptor antagonists (54.3%), Biguanides (64%), Sulfanauria (49.8%), and dyslipidemia drugs (82.3%).Adherence to recommended diets was low, with only 22.5% and 25% following diabetic and low sodium diets, respectively. Aerobic exercises and jogging were undertaken by 21.3% and 51%, while larger proportions abstained from aerobic exercises (31.3%), exercise (64.3%), sports (89%), yoga (96.8%), and Ayurveda (90.8%) for NCD management.The study's outcomes emphasize the urgency of overcoming barriers to medical service access and adherence for optimal NCD management. Tailored interventions can enhance patient outcomes, alleviate healthcare strain, and curtail NCD-related burdens on societies.