Introduction Racial and ethnic inequity in pain management have been well documented in peer-reviewed literature. A recent publication suggested inequity in opioid prescription rates for Black and White patients among 310 large and racially diverse health systems, including Froedtert & the Medical College of Wisconsin (F&MCW). This prompted F&MCW to further investigate its own opioid prescription data. Pharmacists have led similar investigations to evaluate racial inequities in health care, and are well-positioned to assess opioid prescribing. Objective To investigate opioid prescription inequity between Black and White patients treated by F&MCW. Methods The pain stewardship pharmacist led a multidisciplinary team to collect and analyze ambulatory opioid prescription data for fiscal year 2021. Primary outcomes included number of prescriptions, minimum morphine equivalent daily dose (MinMEDD), and maximum morphine equivalent daily dose (MaxMEDD). The primary independent variable was the reported race/ethnicity in the medical record. Linear regression models for each outcome were performed first unadjusted, and secondly adjusted for patient demographics, complexity, and comorbidities. Results A total of 122 738 prescriptions for 47 939 patients were analyzed. Using the unadjusted model, non-Hispanic Black (NHB) patients had a significantly higher number of prescriptions compared with non-Hispanic White patients (beta: 0.62; 95% confidence interval [CI]: 0.52, 0.71; P < .001) as well as MinMEDD (beta: 3.33; 95% CI: 2.58, 4.08; P < .001) and MaxMEDD (beta: 2.32; 95% CI: 1.36, 3.28; P < .001). However, the degree of significance decreased for all measures in models adjusted for patient demographics and complexity, and significance was lost when adjusted for individual comorbidities. Conclusion Observed racial differences in unadjusted and partially adjusted analyses were primarily due to higher rates of key comorbidities in NHB patients. This analysis demonstrates the importance of adjusting for relevant confounding variables before drawing conclusions for differences in care between patient populations. Pharmacists can use their position and skill set to take a leading role in such assessments.