The aim of the study was to evaluate Governance of Pharmaceutical products at health facility level in Mbeya City Council. Specifically, the study aimed at assessing the process of procurement and receiving of pharmaceutical products; determining the factors of storage capabilities in provision of services to end user; identifying the factors of staff skills and competences as well as evaluating the health facility budget, its challenges and implementation of direct health facility financing for public facilities. The data were collected by using Questionnaire, Interviews, Observation and Document Review. The researcher employed cross sectional design with the sample size of 150 respondents which was selected by using purposive sampling techniques. Data were collected and analysed both quantitatively and qualitatively by Descriptive statistics and multiple regression model assisted by SPSS version 21. The study findings reveal a big difference between public and private health facilities in the process of procurement and receiving, as well as big and small facilities. Also, for the case of storage capabilities, it has revealed that, most of private and small public health facilities do not have capacity for storage of pharmaceutical products, and the budget is a challenge for public health facilities where both depends support from central government. Moreover, are staff skills and competences where most of staff lack training, teamwork, experience and are not involved in decision making for governance of pharmaceutical products. The study also reveals the improved health system is vital to the Government having society that are assured with the services where the improved system will enhance each level of the facility to provide service accordingly, so having well and controlled pharmaceutical products at each level that will improve customer satisfaction The study recommends the Government especially ministry of Health to have a policy for health system that will improve the control of Pharmaceutical products in the areas of Procurement, Receiving, Storage and Distribution of those products to patient for both public and private, large and small health facilities.