Nigeria's pharmaceutical waste management (PWM) faces significant challenges due to inadequate infrastructure, evolving regulations, and socio-cultural barriers. This mixedmethods case study investigates current PWM practices, awareness levels, and potential solutions. Survey results (n=84) reveal a paradox: 87.8% of respondents know about pharmaceutical waste hazards, and only 18.1% are "very familiar" with proper disposal techniques, indicating a critical gap between awareness and action. This is corroborated by qualitative interviews with healthcare professionals citing inadequate training and resources. The study identifies limited infrastructure, weak regulatory enforcement, and socio-cultural factors as key barriers. While 83.1% of respondents perceive a link between healthcare sector growth and increasing pharmaceutical waste, there is also a strong consensus (95.2%) that raising awareness can positively impact PWM policies. Interviewees emphasize the need for comprehensive guidelines, stricter enforcement, targeted training, and infrastructure investment. The study's findings have significant implications for policymakers, highlighting the need for comprehensive regulatory reforms, infrastructural investment, and educational initiatives to address the multifaceted challenges of pharmaceutical waste management in Nigeria. Further research should explore the perspectives of diverse stakeholders, incorporate longitudinal and comparative studies, and investigate the economic aspects of PWM. By implementing a multifaceted and collaborative approach, Nigeria can move towards a more sustainable and effective system for managing pharmaceutical waste and protecting public health and the environment.