BACKGROUND: The World Health Organisation estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly. OBJECTIVE: To assess the prescribing and dispensing practices of public health facilities in the Southern region of Malawi. METHODS: The study was cross-sectional in nature using both retrospective and prospective data from thirty (30) encounters selected by simple random sampling in 24 public health facilities. The study was based on the prescribing indicators, patient care indicators and health facility indicators as stipulated by World Health Organization. RESULTS: A total of 24 health facilities were sampled. The study established that a high percentage of drugs prescribed are generics (99.4%). The study also established that most of the drugs prescribed are on the essential drugs list (99.6%). About one quarter of drugs were adequately labeled. CONCLUSION: In general, the prescribing and dispensing practices in the health facilities are fairly good and are not far from the standard WHO requirements. Out of the 13 indicators, the study showed that the facilities were doing well on nine (9) i.e. average number of drugs prescribed; encounters with an injection prescribed; drugs prescribed by generic names; drugs actually dispensed; correct patient knowledge of dosage; availability of key indicator drugs; drugs prescribed on EDL and availability of prescribers. The facilities did not do well on five (5) i.e. encounters with an antibiotic prescribed; average consultation time (min); average dispensing time (min); drugs adequately labeled and availability of dispensers.