Introduction: The environment should be protected against dangerous pollutants for a sustainable life. This involves the prohibition of unfit pharmaceuticals from entering sewage systems or drinking water infrastructure. This study aimed to determine how unfit medicines are disposed of in public health facilities and community pharmacies in Nyamagana District, Tanzania. Methods: A structured questionnaire was used to conduct a cross-sectional study of 76 facilities to determine how unfit medicines were disposed of. Participants in the study were all healthcare workers who were in charge of the respective facility. STATA version 14 was used to analyze the coded data. Results: A majority of facilities, 45 (59.2%), had never disposed of unfit medicines. The common disposal method in community pharmacies was burning in open containers (64.0%), while the common method in public health facilities was incineration (83.3%). These results were statistically significant, with P-values of 0.007 and 0.003, respectively. High disposal costs were identified by half of the facilities as a barrier to proper disposal of unfit medicines, while long and complex disposal procedures were mentioned by 20 (26.3%). Conclusion: The Nyamagana district’s community pharmacies and public health facilities were found to have poor practices for disposing of unfit medicines. Almost half of the participants who discarded unfit medicines did so by burning them in open containers. This has the potential to pollute the environment. It is recommended that all personnel in charge of medicine management follow the Tanzania Medicines and Medical Devices Authority’s (TMDA) unfit medicine disposal guidelines.
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