Effective and skilful communication is crucial and an important element in the quality of nursing care. This enables nurses to assess patients' needs and provide them with the appropriate physical care, emotional support, knowledge transfer and exchange of information. However, nurses find it difficult to communicate effectively and therapeutically with their patients. Aim: To identify the nurses' and adult inpatients' perceptions of barriers to effective nurse-patient communication. Methodology: A descriptive study was used to collect data from nurses (n=40) and adult inpatient (n=63) in multidisciplinary wards in a private hospital in Malaysia. Two sets of self-administered questionnaire for the two different groups of participants, the patients and nurses were used. Data were analysed using the SPSS version 20.0. Results: Nurses and adult in patient perceived heavy workload, dialect and negative attitudes towards nurses as main barriers that hinders effective communication among nurses and patients. Conclusion: Communication places an important part in patients' satisfaction of care and the ability of the nurse to provided patient centred care. Nurses should take in to account those communication barriers that affect the patients and be confident enough to take the first step to initiate communication and be able to handle patients' dynamic emotions.