Evaluating instruction following capabilities for multimodal, multi-turn dialogue is challenging. With potentially multiple instructions in the input model context, the task is time-consuming for human raters and we show LLM based judges are biased towards answers from the same model. We propose MMMT-IF, an image based multi-turn Q$\&$A evaluation set with added global instructions between questions, constraining the answer format. This challenges models to retrieve instructions dispersed across long dialogues and reason under instruction constraints. All instructions are objectively verifiable through code execution. We introduce the Programmatic Instruction Following ($\operatorname{PIF}$) metric to measure the fraction of the instructions that are correctly followed while performing a reasoning task. The $\operatorname{PIF-N-K}$ set of metrics further evaluates robustness by measuring the fraction of samples in a corpus where, for each sample, at least K out of N generated model responses achieve a $\operatorname{PIF}$ score of one. The $\operatorname{PIF}$ metric aligns with human instruction following ratings, showing 60 percent correlation. Experiments show Gemini 1.5 Pro, GPT-4o, and Claude 3.5 Sonnet, have a $\operatorname{PIF}$ metric that drops from 0.81 on average at turn 1 across the models, to 0.64 at turn 20. Across all turns, when each response is repeated 4 times ($\operatorname{PIF-4-4}$), GPT-4o and Gemini successfully follow all instructions only $11\%$ of the time. When all the instructions are also appended to the end of the model input context, the $\operatorname{PIF}$ metric improves by 22.3 points on average, showing that the challenge with the task lies not only in following the instructions, but also in retrieving the instructions spread out in the model context. We plan to open source the MMMT-IF dataset and metric computation code.