ObjectiveThis study aimed to evaluate student engagement in a pharmacotherapy course with required attendance, identify intervals where students were most and least likely to be engaged, and assess student perceptions of the importance of engagement. MethodsIn 2022, the pharmacotherapy course faculty implemented a graded attendance policy. A survey instrument was developed to gauge student engagement throughout in-class sessions and included 3 questions regarding engagement to determine whether students were on-task, off-task–related, or off-task–unrelated. Each week throughout the semester, students were randomly surveyed for a beginning, middle, and end time point. A second survey was utilized to collect perception data from students regarding attendance and engagement. The perception survey was released during the midpoint of the semester and at the end of the semester. ResultsThe overall attendance rate was 91.1% (SD 4.64%) for the semester. Generally, students reported being on-task when surveyed. The average weekly tasks rates were 77.7% on-task, 15.8% off-task–related, and 6.5% off-task–unrelated. For the perception survey, both time points had a high response rate (82.8% midpoint survey, 77.1% end of semester). Most students had positive perceptions regarding mandatory attendance, engagement, and pre-class preparation. ConclusionThis study endorses high levels of student engagement in a pharmacotherapy course with required attendance. In addition, student perceptions were generally positive regarding required attendance. Future investigations need to be completed on the non-performance benefits of attending classes.