A retrospective study was conducted on 450 cases, to study the drug utilization review and prescribing pattern in patients with respiratory diseases in a tertiary care hospital. Among 450 cases majority of the cases were COPD (30.9%). Nebulizer was the preferred dosage form for BA (36%), COPD (38%) and Bronchitis (39%), injections for LRTI (30%), syrups for URTI (37%) and capsules for Pharyngitis (62%).46 prescriptions were found to have drug-drug interactions, Dexamethasone + Theophylline and Dexamethasone+ Budesonide were found to have 28.26% of interactions. B2 adrenergic receptor agonist was most commonly prescribed class of drug for BA (31%), COPD (32%), LRTI (35%), URTI (39%) and Bronchitis (43%) where in the cases of Pharyngitis, Antihistamines (82%). In BA (31%), COPD(67%), LRTI(45%) and Bronchitis(50%), Ceftriaxone was the preferred class of Antibiotics while Amoxicillin for URTI (80%) and Pharyngitis (68%). Out of 1472 prescribed drugs, 904(61%) drugs were prescribed in brand name and 568 (39%) drugs were prescribed in generic name, 61% of drugs were used as monotherapy while 39% of drugs were used as combination therapy. Asthalin (45%) was the most commonly prescribed drug according to Essential Drug List. From the study, it is concluded that the doctors were aware about the use of drugs, safety of prescribing drugs from Essential Drug List (EDL) but there was a lack of knowledge on prescribing with generic names. In the present study most patients were on monotherapy but Patients with respiratory diseases mostly require more than one drug to control the symptoms.