Background: Medicines are the essential tools for prevention, cure and control of diseases. If these medicines are ineffective then their aftermath can cause wastage of resources. Medicines lose their required effectiveness due to inadequate storage at required temperature.Objective: The objective was to estimate the proportion of pharmacies with high temperature (>25°C) inside pharmacy outlets in two talukas (sub-districts) of district Thatta, Sindh.Methodology: An exploratory cross sectional study design was conducted from August 2013 to August 2014. All pharmacies of the two talukas were approached by doing a census. Descriptive analysis was done to calculate the frequencies and proportions.Results: All pharmacies (n=62) had a temperature of >25°C inside the pharmacies. Medicines were exposed to sunlight in 39 (63%) of the pharmacies and 39 (63%) of pharmacies had refrigerators to keep insulin and vaccines. Median duration of electricity shut downs was 12 hours per day and 11% of the pharmacies had back up power supply.Conclusion: More than a quarter of pharmacy owners were aware about maintaining the required temperature of < 25°C but none of them were maintaining required temperature. Considering the electricity shut down, it is important to make cost effective and long term strategies to maintain the efficacy of medicines. Proper legislation needs to be enforced with continuing training programs for pharmacy owners. Further research is required to explore different ways of maintaining required temperature to ensure the adequate efficacy of medicines.