Library websites are important for marketing library services and providing access to electronic resources. To determine the extent and quality of medical college (school) library websites in Pakistan, according to predetermined criteria. A checklist of 40 items was developed from the literature on academic library website evaluation as well as observation of known best practice. The checklist was used on the 45 medical college websites that fitted initial inclusion criteria. Of the possible 114 candidates for inclusion, 52 institution websites contained no information about the library, 17 only provided minimum details, leaving 45 medical college library websites that could be included. Library websites lack uniformity, and most of the important features as only three library websites contained more than 20 items from the checklist. The Agha Khan University Medical College, Karachi library website contained the highest (27) number of items. The findings indicate the design of medical college library websites is generally inadequate in Pakistan. The websites are not performing a useful role in communicating with faculty and students. The findings point to inadequate website design skills among librarians or the lack of co-operation with professional website designers. Marketing of library services and good customer relations demand improvements in the information architecture of medical college library websites as well as continued maintenance of the content to ensure that it is up to date.