A pharmacy based prescription audit was undertaken in the medical emergency unit of a tertiary care hospital to determine the frequency of prescribing of parenteral anti-infective agents. During the study period, 885 patients were screened. The analysis was done for the number of parenteral anti-microbials in each prescription frequency of individual drug prescribe number and dose unit (DDD), frequency of age and sex, site of infection and daily cost incurred by the patient. It was found that 400 patients (45.2%) received parenteral anti-infective agents. Cephalosporins, aminoglycosides and metronidazole accounted for about 70% of total antimicrobial use. More than 50% of patients had culture sensitivity reports available. The mean (standard deviation, SD) daily cost of antibiotic was USD 3.8 (7.7), median; range 2 (0.1-85.7). Two anti-microbials per prescription were indicated in most of the patients (43.88). In conclusion we have provided an overview of parenteral anti-infective use in medical emergency, which may serve as a basis for intervention and improvement in prescribing pattern of parenteral anti-microbials.