OBJECTIVES: The Pharmacy and Therapeutics Committee (P&TC) is a policy recommending and enforcing body which oversees the adoption of effective formulary system within the health care organization, the aim of the study is to explore the characteristics of P& TC in tertiary and secondary hospitals in Riyadh city, Saudi Arabia. METHODS: A cross-sectional survey targeted hospital pharmacy mangers in Riyadh city in 2014. The survey gathered information about P&TC organizational, communicational and functional characteristics. RESULTS: Of 30 hospital pharmacies, 23 (76.6%) pharmacy managers responded, 21(70%) hospitals met the inclusion criteria, 15 (71.4%) are governmental and 6 (28.6%) are private hospitals. Of 21 hospitals, 20 (95.2%) have P&T Committee. 15 (71.4%) committees have all required written policies and procedures that govern the committee business. The average total number of the P&T committee members is 13.5 (SD=5), and dominated by physicians, pharmacists, and nurses (6.9 (SD=3.4), 2.7(SD=1.2), and 1.4(SD=0.8)) respectively. 89.5% of these committees are chaired by physicians and 100% of them are coordinated by the pharmacists. Only 9 (45%) of the committees distribute the meeting agenda to their members 6 days or more before the meeting date. The average number of meetings is 12 (SD=6) meeting per year, drug availability, formulary change updates, drug safety related issues were frequently discussed in each meeting of 11(55%) hospital P&T committees. Formulary non adherence is less frequently, and prescribing guidelines is the least frequent. The average number of drugs deleted or added to the formulary are 6.3(SD=5.9), 19.2 (SD=18.9) drug per year, respectively. CONCLUSIONS: Adopting P&T Committee in Saudi governmental hospitals is a common practice, however, it considered in early stage in private hospitals and more likely to be contributed to the accreditation requirements, therefore, more study to be done to study the quality of the committees in private hospital to ensure the effectiveness of formulary system.