Background: Supply chain risk management is the process of identification, assessment,rnmitigation, and monitoring of risks. Pharmaceutical suppliers and distributors face multiple risksrnthat disrupt the supply of drugs interms of quantity, quality, and delivery at the right place andrntime to the right customer. Therefore, caution must be taken as health is critical andrnpharmaceuticals are unique. rnObjective: To analyze the pharmaceutical supply chain risks and assess the risk managementrnpractice of the Ethiopian Pharmaceuticals Supply Agency. rnMethod: An explanatory and descriptive case study design was employed. Totally, 101 samplesrnwere involved in the study selected through purposive sampling technique. An interview guide,rnquestionnaires, and risk checklists were used to collect quantitative and qualitative data fromrnrespondents. The Excel-derived failure mode and effect analysis template, and SPSS version 23rnwere used for the data analysis. Thematic analysis of qualitative data was also employed. rnResult: Eighty nine risks were identified and categorized into six groups. Among these, supplyrnand demand side risks take the priority in affecting the supply chain operation. Inability to meetrncustomer demand, lead time variability, and poor logistics performance of suppliers are underrnhigh risk score categories. Most of the respondents, 45 (44.6%), agreed that the risk managementrnpractice at Ethiopian pharmaceuticals supply agency is at its infancy. Risk identification methodsrnbeing used are found to be risk estimation, previous risk assessment, and brainstorming sessions.rnThe most applicable risk management tools are inventory optimization (29.9%), sales (22.4%),rnand operation planning tool (27.6%). The overall implementation of risk management strategiesrnare below the average. Supply side (β = -2.171, P ˂ 0.020), process (β = -0.979, P ˂ 0.026), andrncontrol (β = -1.694, P ˂ 0.004) risks negatively affect the supply chain performance, while riskrnmanagement practices (β = 6.440, P ˂ 0.002) affect it positively. rnConclusion: Supply side risks took the primary position during prioritization followed byrndemand side and operational risks while environmental risks were at the least position. Thernoverall risk management practice of the Ethiopian pharmaceuticals supply agency is weak. Thernlevel of implementation of risk management processes are low while the applicability of riskrnmanagement tools are above the average level in the last 5 years history of the agency. Supplyrnside, process, and control risks affect the supply chain performance negatively. However, supplyrnchain risk management practices have a positive impact on performance. rnRecommendation: The Ethiopian pharmaceuticals supply agency should establish a separaternteam that primarily assess, analyze and control supply chain risks at all hubs. The agency shouldrnalso be engaged in more scientific methods of risk identification methods like surveys, and riskrnassessment to identify, control, and minimize impacts of risks.