The Islamic Republic of Pakistan is the sixth most populous country in the world. While exploring the history of the development of the pharmacy profession, the author discovered that the late Sheikh Nabi Buksh was the first to start a general store with a pharmacy in 1863. After the independence of Pakistan (14 August 1947), the University of Punjab became the first institution to develop a three-year bachelor programme in 1948 which was extended to four years in 1978-1979. In 2003, a step towards further change was seen when the Higher Education Commission (HEC) upgraded its BPharm programme to a five-year Doctor of Pharmacy (PharmD) programme. At the moment the Pakistani PharmD programme is facing a number of problems which are acting as a hurdle to Pakistani pharmacists and the establishment of pharmacy practice as a profession in Pakistan. This perspective will highlight these challenges so that the HEC and the Pakistan Pharmacy Council (PPC) can intervene to modify the Pakistani healthcare system in order to establish a good foundation for practicing pharmacists and to develop strategies to cope with the challenges accordingly.