Abstract   Background Medicines can be potentially dangerous when used wrongly. This work examined drug combinations in pain management among attendants in retail drug outlets in  Obiaruku, Delta State, Nigeria.       Objectives The objective of this study was to describe drug combination in the management of pains by attendants working in community pharmacies and patent medicine shops (PMSs)         Method This was a cross-sectional descriptive study using the ‘’surrogate shopper’’ approach to explore the real day-to-day practices and extract required information in twelve retail drug outlets located in the study area. Conversations were tape recorded and thereafter composition of   single doses of pain relievers   recommended by attendants   were analyzed. Results A total of 12 retail outlets were visited. The average number of pills contained in a single dose pain reliever was 6.80±2.35 (for pharmacy outlets) and 5.33±1.32 (for PMSs), p>0.05. Piroxicam (14, 73.7%)   was   most frequently used NSAID. More than half,   63.2% of the attendants included single tablet of Prednisolone, 5mg in their pain relief combination. Other drugs not indicated for analgesia were included in the single dose combo. This includes Vitamin B complex (2, 10.5%), cod liver oil,   Sulfadoxine – pyrimetamine (1, 5.3%), Salbutamol and Ferrous sulphate (1, 5.3%) and multivitamin (12, 63.2%).There was no   significant difference in pain management practices between Pharmacies and Patent medicine stores (PMSs)   (p>0.05). Conclusion Polypharmacy and irrational use of NSAIDs was   a common practice among shop attendants in retail drug outlets, resulting in avoidable drug therapy problems and posing serious risk to public health.