ABSTRACT… Introduction: Due to irresponsible and unsafe methods of drug disposal employed by consumers pharmaceutical waste enters the ecosystem, ultimately having a detrimental effect on both human health and environment. Objectives: The purpose of the study is to measure attitude and practice of local community in Karachi, Pakistan regarding safe disposal of unwanted medicines and assess willingness of participants to take part in a medicationtake-back program. Study Design: A two-phase observational study was conducted using convenience sampling. Period: January to February, 2016. Methodology: In Phase I (n = 200) students enrolled in various health sciences institutions in the study were asked to take part in the survey. In Phase II(n = 300) household consumers were contacted by telephone and social media. Results: Participants (response rate 84.4%) were given a questionnaire to explore their attitudes towards medicine disposal. More than half of the consumers surveyed reported storing unused/expired medications in their homes, and majority threw away unwanted medicine in the garbage. The most common reason was unawareness of expiry date (32.7%). Only 12.32% reported returning medication to a pharmacy for disposal. Majority of the consumers had never received advice about medication disposal by a health care provider but were aware of the possible negative consequences and were willing to participate in national pharmacy take-back programs if implemented by the government. Conclusions: Our findings suggest that effective communication and established protocols will promote appropriate disposal practices. Public services in Pakistan, and especially pharmacies, must play a more proactive role in this regard.