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Background: Unwanted medicines are defined as expired, unused, damaged or contaminated pharmaceutical products. Improper disposal of unwanted medicines leads to many health and environmental hazards. The World Health Organisation recommends that unwanted medicines should always be disposed properly. The main objective of this study was to assess the knowledge, practices and perceptions on the disposal of unwanted medicines among pharmacists in Sri Lanka.Methods: A cross-sectional study was carried out among pharmacists in 40 private retail pharmacies in the Northern, Eastern and the Western provinces within a period of three months. The pharmacies were selected via stratified randomised sampling in each district. The most experienced pharmacist in each pharmacy was recruited for data collection. A pre-tested, self-administered questionnaire was used. The ethics approval was obtained (Ref: EC-12-190). The data was represented using simple descriptive statistics.Results: The data was collected from 40 pharmacies. Among the pharmacists, 65% were males. The majority answered that burning and landfill as the most appropriate methods of disposal for most of the types of medicinal waste. A significant number of pharmacists were not aware about the method of disposal for anti-infective agents and anti-neoplastic agents. The majority perceived the seriousness of environmental damage caused by disposal via trash or sink. A majority was not agreeing to have pharmacies as collecting centers for unwanted medicines. A discrepancy between the pharmacists’ perceptions and the practices was observed.Conclusions: The level of knowledge, practices and perceptions among pharmacists on unwanted medicines disposal was substandard and needs attention.