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Stefanie P Ferreri,1 Tamera D Hughes,1 Margie E Snyder2 1UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7574, USA; 2College of Pharmacy, Purdue University, Indianapolis, IN 46202, USACorrespondence: Stefanie P FerreriPractice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, 301 Pharmacy Lane, Chapel Hill, NC, 27599-7574, USATel +1 919 843 9765Fax +1 919 843 3861Email stefanie_ferreri@unc.eduAbstract: Medication therapy management (MTM) services have evolved as a means for pharmacists and other providers to assist patients and caregivers in improving therapeutic outcomes and reducing health care expenditures. More than a decade has passed since the Medicare Modernization Act of 2003 provided pharmacists with the opportunity to deliver MTM services to Medicare beneficiaries. MTM continues to offer pharmacists the opportunity to use their knowledge; yet, pharmacists have reported challenges with service delivery. Identifying the challenges that affect MTM services in pharmacy practice is necessary in order to seek improvement to MTM delivery. This narrative review explores the current challenges pharmacists face with MTM delivery, summarizes potential solutions for addressing challenges, and seeks to incite further debate, service reconfiguration, and ultimately service improvement of pharmacist-provided MTM services.Keywords: community pharmacy services, community pharmacy, medication management, drug therapy management, pharmaceutical services