OBJECTIVES: The study investigated the local retail drug market to determine the prices, availability and affordability of antimalarial medicines to generate information for improving access to ACTs METHODS: A cross-sectional survey was conducted in retail outlets in Enugu urban SE Nigeria in 2011, based on WHO/HAI recommendations. Nine medicines from seven categories of antimalarial drugs were surveyed in a sample of 38 retail outlets, selected randomly by type and location. Data was collected by structured interviews, in-depth interviews, and retail audits from both private retail pharmacies and patent medicine vendors. RESULTS: The market was highly characterized by a wide range of antimalarial medicines, averaging 10 brands per outlet. SPs and the ACTs were the most dominant categories accounting for over 70% of market volume. SPs were the cheaper and most popular agents particularly in PMVs while the ACTs were the most prescribed agents dominant in retail pharmacies. Prices of the drugs ranged from $0.13 to $8.17 per adult oral dose. ACTs were the most expensive antimalarials with a median price of $5.23 ($1.83 - $8.17) in a country where over 50% of the population lives below $2 a day, making them unaffordable for majority of the low-income population. CONCLUSIONS: The use of ACTs has become very significant, but still below the required policy level as the drugs of choice in malaria treatment, limited by high prices and inadequate information. Results confirm that in many countries access to ACTs is hindered by unaffordable prices for majority of the population in addition to limited information on their relative efficiency in malaria treatment. Procurement is the most determinant of high cost, making it the key policy target for price reduction for improved affordability. Hence the expected impact of the AmFm will certainly boost access to the ACTs and would significantly change study findings