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Pharmaceutical waste (such as expired and unused drugs, partially used drugs, sharps, syringes, plastics, glassbottles, damaged vials and ampoules, tablet packages) not only poses threat to the environment but also indicateswastage of valuable resources. If not handled, it was result into contamination of ground water, spread of infections,air pollution, and accumulation in the food chain and wastage of valuable resources. Therefore, this study assessedthe pharmaceutical waste management systems used by selected hospitals in western Uganda. A quantitativedescriptive cross-sectional was carried out using a self-administered data collection questionnaire, among 90Hospital staffs from 3 selected Hospitals determined by Yamane, (1967)Formula and a simple random samplingmethod. The data coded and analyzed using SPSS, results in Frequency and percentage tables and charts. Accordingto the study findings, majority 53(58.9%) were females and 37(41.1%) were males, majority with experience of 0-5years mostly 62(68.9%), and only 3(3.3%) had worked for about 21 years and above. More than a half 51(56.7%) weresingles and 39(43.3%) were married. Mostly 49(54.4%) Nurses, 23(25.6%) were laboratory technicians, pharmacytechnicians were 9(10%) and only 4(4.4%) were causal workers. mostly 20(22.2%) used and /or expired drugs,minority being syringes and lastly were broken glasses and plastics each with 4(4.4%). Cans are used to sort thewastes according to type 84(93.3%), and majority 80(88.9%) reported to be using a combination of red bin, black binand yellow bin as well as a safety box for the sharps and transported mostly 50(55.6%) by manual handling; and theminority, 11(12.2%) use a wheeled cart. While methods used included majorly 75(85.2%) by incineration; and /orincineration in combination with autoclave method 7(8%). The rest were disinfection, landfills of a combination, eachbeing reported to be used by 2(2.3%). Bad Smell during waste Burning 51.35%, followed by Unskilled staff inEquipment operation(autoclave) 21.62%, Bottles not completed 10.81% and the others reported late communicationsconcerning wastes, delay to pick the bins from the collection points to disposal areas and less personal protectiveequipment for those responsible to collect the bins to the disposal site, each with 5.401%. However, 58.9% of thestudy participants could not mention or report any challenge associated with waste disposal and/or management.The incinerators used as reported by 85.2% of the study participants thus the main means of pharmaceutical wastedisposal, they are not suitably located in that they are surrounded either by plantations or by residential (66.7%).Similarly, 66.7% (2/3) lack a temperature monitor and 1/3 (33.3%) is located <500meters while2/3(66.7%) werelocated ≥500 meters. Nonetheless, all the hospitals had their incinerator chimneys installed >3meters high. Inconclusion, Pharmaceutical waste disposal at the selected sites is mainly by incineration but owing to unskilled staffin waste management/waste machinery operation, unsuitability of the machine location and lack of enough personalprotection equipment, thus; incomplete burning of some wastes, bad smell associated with the nearly situatedresidents and/or agro-farms.