Objective Patient use of over-the-counter (OTC) medicines contributes to improving public health and reducing public pharmaceutical expenditure. However, little is known of patient experiences of pharmacy distribution and services related to OTC medicines. The aim of this study is to explore patient experiences of purchasing OTC medicines in Flemish community pharmacies. Method Data were gathered from an anonymous postal questionnaire survey of patients purchasing OTC medicines in a random sample of Flemish community pharmacies in April 2008. The self-administered questionnaire related to the most recent purchase of OTC medicines by a patient in a community pharmacy. The questionnaire included questions about: (a) sources of information about OTC medicines; (b) the patient relationship with pharmacist and physician; (c) organization and layout of the pharmacy; (d) distribution channels; and (e) patient satisfaction. Questions were generally measured using Likert scales. The questionnaire was piloted among patients. Results One hundred and fifty-five pharmacies consented to distribute questionnaires to five patients each, yielding a total of 358 useable questionnaires (response rate of 46%). The first point of contact about OTC medicines was the pharmacist (61% of patients), followed by the physician (29%). Newspapers and the internet were not viewed as primary sources of advice on OTC medicines. Patients tended to purchase OTC medicines for the acute treatment of pain, gastro-intestinal conditions, common cold, cough or musculo-skeletal pain. More than 75% of patients felt that pharmacists provided sufficient information about the health condition and OTC medicine use. About one-third of patients did not wish the physician to be informed of their OTC medicine use. Patients did not seem to agree with distribution channels for OTC medicines other than the community pharmacy. Conclusions Flemish patients were satisfied with pharmacy distribution and services related to OTC medicines. They see an important role for pharmacists and physicians to accompany them in their OTC medicine use. Our results highlighted the need to strengthen communication between patients, pharmacists and physicians. It is also recommended that pharmacists keep an individual record detailing patient use of OTC and prescription medicines.