Background: As high as 40 percent of the health care budget was expended onrnpharmaceuticals in developing countries, however significant proportions of thernpopulation do not get access to even the most essential medicines. Weakrnpharmaceutical inventory management is one of the factors that may contribute tornthe problem as it can result in irrational utilization of drugs, blockade of financialrnresources and/or stockout of essential medicines. The objective of this study was tornassess the performance and challenges of the pharmaceuticals inventory managementrnof public health facilities in West Shewa Zone, Oromia Region, Ethiopia. Generally, thernmethods used in this thesis have been guided by the recommendations of the LogisticsrnIndicator Assessment Tool (LIAT) developed by USAID/DELIVER Project. Accordingly,rnfacility-based cross-sectional descriptive study design was followed. Among 98 totalrnhealth facilities, 17 of them were chosen by simple random sampling technique. Bothrnqualitative and quantitative data were collected. Qualitative data were collected fromrn10 participants through key informant interview method by using a semi-structuredrninterview guide and analyzed using a qualitative analysis technique (reviewing therninterview thoroughly, categorizing thematically, summarizing and finally writing downrnthe information by stating the finding), while quantitative data were collected using arndata abstraction forms and observation checklist and analyzed using descriptivernstatistics. The data collection period was from May to June 2019. The average shelfrnlife of the selected medicines was 62.22%. None of the selected medicines were stockedrnper the plan in all the facilities. An average inventory accuracy rate was 39.23%. Thernwastage rate in studied facilities was 7.08%. The average order lead time was 31.10rndays. The inventory turnover rate was 8.21 and the average percentage fulfillment ofrna storage condition was 70.88%. Some of the major challenges identified include therninability to dispose of a large quantity of expired medicine, inadequate storage space,rninterrupted supply and inadequate manpower. The inventory managementrnperformance of the study facilities were poor which was shown by lower inventoryrnaccuracy rate, higher wastage rate and lower storage condition. Applying feasiblernmedicine disposal method, fulfilling the required manpower and sharing near expiryrnmedicines with other facilities are recommended.