Introduction <p>Sustained adherence to disease-modifying therapies is essential for preventing relapses and long-term disability progression in people with relapsing–remitting-multiple sclerosis (PwRRMS). Although psychological distress is associated with poor adherence, the independent contribution of psychological resilience remains unclear. This study aimed to determine whether psychological resilience is independently associated with medication adherence (MA) in PwRRMS who are in remission after accounting for psychological distress, disability level, quality of life (QoL), and clinical factors.</p> Methods <p>This study included 165 PwRRMS in clinical remission. MA was assessed using the Medication Adherence Report Scale. Psychological resilience, psychological distress, coping attitudes, and QoL were measured using validated scales, and neurological disability was evaluated using the Expanded Disability Status Scale (EDSS). A multivariate logistic regression analysis was conducted after adjusting for depression, anxiety, stress, coping strategies, QoL, EDSS, and disease duration.</p> Results <p>Compared with poorly adherent participants, those with good adherence reported (60%) significantly higher resilience, lower depression, anxiety and stress symptoms, and better QoL (all p ≤ .01). Adherence was positively associated with resilience and negatively associated with psychological distress. Regression analysis revealed psychological resilience was the only independent predictor of good adherence (p = .016), whereas psychological distress, QoL, and disability level were not retained.</p> Conclusions <p>Psychological resilience appears to be a key psychological resource supporting sustained treatment adherence in RRMS, independent of emotional distress, disability severity, or QoL. Routine clinical care may benefit from screening for resilience and the incorporation of resilience-enhancing strategies to improve long-term adherence and optimize patient outcomes.</p>