OBJECTIVES: Self-medication in both rural and urban population in Pakistan is an increasingly growing concern. Both literate and illiterate people irrespective of age and gender practice self-medication, which is in more than 50% of cases inappropriate. The aim of this study was to survey over-the-counter availability of medicines and self- medication pattern among the rural and urban population of Karachi, Pakistan.  METHODS: Over 1300 volunteers of ages (between 20-80 years) and both genders were surveyed for their self-medication pattern. Medicines were grouped as antimicrobials and non-antimicrobials. RESULTS: CONCLUSIONS: The unregulated over-the-counter availability of medicines and the practice of self-medication are increasingly growing threats to the health care system in Pakistan.  The inappropriate medications not only add to mortality and morbidity, but also cause increased cost of treatments. Such habits must be shunned through legislation and community awareness.