Background <p>Medical ethics is an applied branch of ethics that addresses the moral issues and challenges encountered in clinical practice. Medical ethics should be adhered to during clinical practice. Non-adherence to medical ethics may cause unnecessary burdens and consequences on patients, deterioration of health status, exposure to other health problems or diseases, unnecessary surgery, additional medical expenditure, psychological distress, bodily injury and death. Globally, adherence to medical ethics is not uniform, while in Ethiopia, there is limited information on adherence to medical ethics and its determinants. Therefore, this study aimed to assess the level of adherence to medical ethics and its determinants among medical doctors in Ethiopia.</p> Methods <p>An institution-based cross-sectional study was conducted among 1,012 medical doctors from 01 August 2024 to 31 October 2024 in Ethiopia. A multistage sampling technique was applied to select the respondents. A structured self-administered questionnaire was used for data collection. Relevant descriptive statistics was done for all variables. Multivariable binary logistic regression analysis was used to identify factors significantly associated with adherence to medical ethics.</p> Results <p>The study revealed that only 588 (58.1%) medical doctors had good adherence to medical ethics. Year of medical ethics course (AOR: 1.77; 95% CI: 1.27, 2.46), integration of medical ethics course with clinical practice (AOR: 1.34; 95% CI: 1.08, 1.72), pre-service orientation on medical ethics (AOR: 1.60; 95% CI: 1.15, 2.23), in-service training on medical ethics (AOR: 1.44; 95% CI: 1.11, 1.89), institutional ethics committee (AOR: 1.54; 95% CI: 1.11, 2.13), clinical communication skills (AOR: 1.68; 95% CI: 1.08, 2.61), clinical leadership skills (AOR: 1.74; 95% CI: 1.07, 2.86), knowledge of medical ethics (AOR: 2.56; 95% CI: 1.72, 3.83), and attitude towards medical ethics (AOR: 10.38; 95% CI: 7.02, 15.33) were significantly associated with adherence to medical ethics.</p> Conclusions and recommendations <p>Adherence to medical ethics among medical doctors was low. Year of medical ethics course, integration of medical ethics course with clinical practice, pre-service orientation on medical ethics, in-service training on medical ethics, institutional ethics committee, clinical communication skills, clinical leadership skills, knowledge of medical ethics, and attitude towards medical ethics were significantly associated with adherence to medical ethics. Therefore, the implementation of various strategies and interventions is very important to improve adherence to medical ethics among medical doctors in Ethiopia.</p>