Cupping therapy is defined as a therapeutic treatment using evacuated cups being placed to intact or scarified skin to withdraw blood and interstitial fluid filled with causative pathological substances. Clinical practice guideline is crucial to assist in decision making during patient care and promote standardized care which helps to increase quality and patient outcome. Adherence to cupping practice guideline was considered low at 5.3% in prior study (Mahat & Rahman, 2020). Hence, this study aimed to explore barriers of cupping practitioners’ adherence to Malaysian cupping practice guideline. This qualitative study involved three cupping practitioners who agreed to semi-structured interviews. Several barriers of practice guideline use were identified using thematic analysis. Among these are increased cost, lack of practice resources, lack of time, inadequate knowledge on the guideline, lack of agreement, and lack of feeling expectancy. Furthermore, being surrender or tawakkal is notified as a newly emerged barrier from the analysis. Specific measures addressing those should be disseminated and implemented, such as to streamline educational training in enhancing guideline familiarity. Besides, it is essential to have reminder systems such as notification pop-out, email, face-to face session and management chain to assist in guideline use