Background: Currently in Nigeria, prescription only medicines are supposed to be dispensed only with a prescription. The study aimed to reveal the prevalence of prescription only medicine without a prescription and the perception of community pharmacist in Makurdi, Benue State Nigeria towards the phenomenon. Method: The study was carried out between February–April 2019 using simulated patient approach and administration of questionnaire on the pharmacists. Result: Forty pharmacies were surveyed and 100% (29) of the respondents were willing to dispense prescription only medicines without a prescription. Among the respondents, 93% (27) said they do see up to an estimated 30% of POMs without a prescription daily. While 19.2% (5) of the pharmacists do dispense POM without a prescription, 42.3% (11) said they do so depend on the level of education or prior exposure of the client to the medication. Only 38.5% (10) said they will not dispense a POM without a prescription. Most of the pharmacists, 93% (27) agreed that dispensing POM without with a prescription holds potentials for drug abuse, drug misuse, drug dependence with attendant economic consequences. Conclusion: A vast majority of practicing community pharmacists in Nigeria are willing and do dispense prescription-only medications without a valid prescription; for a variety of reasons. This is against existing Nigerian pharmacy laws and the national drug policy.