OBJECTIVES: Antibiotics are among the most commonly prescribed drugs globally. Now a days overuse and inappropriate use of antibiotics have become a very serious issue in Pakistan and a very limited data is available on the use of antibiotics in Pakistan. The study was aimed to evaluate frequency, rates of incorrect prescribing and inappropriate use of antibiotics and to identify any opportunity for its improvement. METHODS: This prospective and point prevalence surveillance study was performed on April 19, 2013 at Bahawal Victoria Hospital, Bahawalpur. Data of all hospitalized patients on antibiotic therapy were collected on a standardized questionnaire. RESULTS: Out of 692 patients 483 (69.8%) patients were given one or more antibiotics. Out of these 483 patients the antibiotic therapy was inappropriate in 266 (55.1%) patients. In 18 (3.7%) patients antibiotic therapy was given on microbiological assay bases while in 465 (96.3%) patients on empirical bases. The wards with the highest rate of antibiotic use were in ENT (96.8%), ophthalmology (96.2%) and urology (95.2%) while highest rate of antibiotic inappropriate use were in pediatrics (90.0%), neurosurgery (88.0%) and dermatology (66.7%). CONCLUSIONS: Overuse, misuse and inappropriate use of antibiotics were detected in this hospital. A close surveillance regarding antibiotic use in hospitals and the forming of new policies concerning antibiotics use is strictly required to improve the appropriate use of antibiotics.