OBJECTIVES: To assess drug use pattern in outpatient departments (OPDs) of two tertiary care hospitals (Bahawal Victoria Hospital and Civil Hospital) of Bahawalpur, Pakistan. METHODS: This was a descriptive, non-experimental and cross-sectional study. For the prescribing indicators, 2,400 prescriptions (10 OPDs per hospital, 120 prescriptions per OPD) were systematically sampled out of the total 1,560, 000 prescriptions written during April 2014 to March 2015. A total of 600 randomly selected patients (300 patients per hospital, 30 per OPD) and all pharmacists available in both hospitals were interviewed to investigate the patient-care and facility-specific indicators. We used published ideal standards for each of the WHO/INRUD indicators. RESULTS: Among the prescribing indicators, the average number of drugs per encounter was 2.8 (SD = 1.3) (optimal value = 1.6–1.8), the drugs prescribed by generic name were 56.6% (optimal value = 100%), the encounters with an antibiotic prescribed were 51.5% (optimal value = 20.0–26.8%), the encounters with an injection prescribed were 0.0% (optimal value = 13.4–24.1%) and the drugs prescribed from Essential Drugs List (EDL) were 98.8% (optimal value = 100%). Among the patient-care indicators, the average consultation time was 1.2 minutes (SD = 0.8) (optimal value ≥ 10 minutes), the average dispensing time was 8.7 seconds (SD = 4.9) (optimal value ≥ 90 seconds), the percentage of drugs actually dispensed was 97.3% (optimal value = 100%), the percentage of drugs adequately labeled was 97.3% (optimal value = 100%) and the patients’ knowledge of correct dosage was 61.6% (optimal value = 100%). Among the facility-specific indicators, both health care facilities had a copy of EDL and key drugs available in the stock were 72.4% (optimal value = 100%). CONCLUSIONS: Irrational use of drugs was observed in both health care facilities. Continuous education of the physicians, increased physician-to-patient and pharmacist-to-patient ratio are some options to promote rational drug use.