Aim The present study assessed adherence, barriers, belief and awareness towards the use of medications among multi‐ethnic community‐dwelling older adults in Malaysia. Medication accessibility, expenditure and perceptions towards medicine labeling among older adults were also evaluated. Methods A cross‐sectional study was carried out in the central region of Malaysia from January to August 2015. The older adults enrolled in an ongoing prospective community‐based geriatric cohort study and prescribed with medicines were interviewed using a 50‐item validated questionnaire. Results Of the 79 older adults interviewed, 39.2% had ≥4 prescribed medications. Most obtained their medications free‐of‐charge from government hospitals (66, 83.5%). Nearly half (35, 44.3%) had trouble reading labels for medicines that they had received. Chinese older adults (P = 0.001) and those with lower monthly household income (P < 0.001) expressed difficulty in reading medication labels. Most (59, 75.0%) were unable to differentiate between generic and brand names of the medications, and 49.4% of the older adults did not know that all medicines had to be registered with the Ministry of Health, Malaysia. Most older adults had positive beliefs about the necessity of their medications, and 50.6% (n = 40) reported high medication adherence. The medication adherence score was negatively correlated with the concerns score (r = –0.5, P < 0.001). Conclusions The findings from the present study provide a unique insight into the diversity of medication use among multiethnic community‐dwelling older adults. Although high adherence to medications and positive beliefs about the necessity of medications were reported by the older adults, their knowledge about medications remained insufficient and they had difficulty in reading medication labels. Geriatr Gerontol Int 2017; 17: 1214–1220.