. Optimal adherence is required for the better treatment outcome from highly active antiretroviral therapy. Though evidence-based regimen changes are being applied incessantly, adherence to those regimens should also be continuously monitored. . To assess the adherence and its determinants toward dolutegravir-based antiretroviral therapy among children in ART clinics in Bahir Dar City, Ethiopia. . Institutional-based cross-sectional study was conducted from March 01 to April 31, 2023. . In this study, 71% of the respondents were on TDF+3TC+DTG-based regimen. The adherence level was found to be 90%. Children's age (AOR = 3.877 [95% CI: 1.130, 13.291]), HIV-serostatus disclosure (AOR = 3.96 [95% CI: 1.43, 10.916]), CD4 counts (AOR = 3 [95% CI: 1.483, 6.069]), and comorbid illnesses (AOR = 0.3 [95% CI: 0.132, 0.707]) were determinant factors. . In this study, the level of adherence to dolutegravir-based antiretroviral therapy was found to be higher with age, disclosure status, CD4 count, and comorbid illness being significant determinants for the adherence.